Reverse Wafer Procedure for Ulnar Impaction Syndrome

Author:

Ozcelik Ismail Bulent1,Jusoh Mohd Hanifah2,Cavit Ali3

Affiliation:

1. Hand and Upper Extremity Surgery Unit, Yeniyuzyil University, Gaziosmanpasa Hospital, El Istanbul Hand and Microsurgery Group, Nişantaşi University School of Health Sciences

2. Department of Orthopedics, Hand and Microsurgery Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

3. Istanbul Haydarpasa Numune Training and Research Hospital, Hand and Upper Extremity Surgery Clinic, Istanbul, Turkey

Abstract

Ulnar impaction syndrome occurs when excessive load across the ulnocarpal joints results in pathologic changes, especially over the articular surface of the ulnar head and proximal ulnar corner of the lunate. The 2 main surgical options in ulnar impaction syndrome are ulnar shortening osteotomy and wafer procedure, whether open or arthroscopically, to decompress the ulnocarpal joint load. However, all of these techniques have their shortcomings and drawbacks. The current study demonstrates a novel technique to decompress the ulnocarpal joint load: the “reverse wafer procedure” for ulnar impaction syndrome. In this surgical technique, we resected the proximal ulnar side of the lunate instead of partial resection of the thin wafer of the distal ulnar head dome in the standard wafer procedure. This technique avoids iatrogenic central tear of triangular fibrocartilage and distal radioulnar joint portal arthroscopy, which is technically demanding while preserving the distal radioulnar joint.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine

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