Background: Ulnar shortening osteotomy (USO) is an effective treatment for the ulnar impaction syndrome. But there has been a concern of osteoarthritis developing in the distal radioulnar joint (DRUJ) if we perform the USO in patients with reverse oblique sigmoid notch. This study was to evaluate the radiographic and functional outcomes following USO in patients with reverse oblique sigmoid notch.
Methods: Between 2002 and 2013, we retrospectively reviewed our patients with reverse oblique sigmoid notch underwent USO in treating the ulnar impaction syndrome. We evaluated the radiographic changes in the DRUJ and their functional outcomes.
Results: We enrolled 22 patients (22 wrists) with an average age at operation of 49.6 years and mean follow-up of 93.2 months. We found that there were changes in the inclination angle of sigmoid notch, from an average of reverse oblique 14.9o preoperatively to a more parallel of 5.1o at the final follow-ups. The functional results at the final follow-ups were good with the mean VAS for pain of 0.3 at rest and 1.4 during activity, QuickDASH of 16.5, and modified Mayo Wrist Score of 91.4. There were 7 wrists (31.8%) noted to have osteoarthritic change, but they did not exhibit significantly worse function, except supination motion, pain during activity, and grip strength.
Conclusions For the patients with reverse oblique sigmoid inclination following USO, the inclination angle would have a tendency to become more parallel and some would develop the osteoarthritic change in the DRUJ, but the functional outcomes could still be good in the intermediate and long-term. The reverse oblique sigmoid inclination seems not to be an absolute contraindication for USO.

Figure 1
Loading...
On 27 Jan, 2021
On 10 Jan, 2021
On 10 Jan, 2021
On 10 Jan, 2021
On 30 Nov, 2020
On 30 Nov, 2020
On 30 Nov, 2020
On 24 Nov, 2020
On 18 Nov, 2020
On 18 Nov, 2020
On 18 Nov, 2020
On 09 Nov, 2020
Received 21 Oct, 2020
Received 20 Oct, 2020
On 05 Oct, 2020
On 03 Oct, 2020
Invitations sent on 02 Oct, 2020
On 02 Oct, 2020
On 29 Sep, 2020
On 28 Sep, 2020
On 28 Sep, 2020
Posted 30 Apr, 2020
On 01 Sep, 2020
Received 25 Aug, 2020
On 07 Aug, 2020
On 05 Aug, 2020
Received 05 Aug, 2020
Received 03 Jun, 2020
On 16 May, 2020
Invitations sent on 13 May, 2020
On 21 Apr, 2020
On 20 Apr, 2020
On 20 Apr, 2020
On 19 Apr, 2020
On 27 Jan, 2021
On 10 Jan, 2021
On 10 Jan, 2021
On 10 Jan, 2021
On 30 Nov, 2020
On 30 Nov, 2020
On 30 Nov, 2020
On 24 Nov, 2020
On 18 Nov, 2020
On 18 Nov, 2020
On 18 Nov, 2020
On 09 Nov, 2020
Received 21 Oct, 2020
Received 20 Oct, 2020
On 05 Oct, 2020
On 03 Oct, 2020
Invitations sent on 02 Oct, 2020
On 02 Oct, 2020
On 29 Sep, 2020
On 28 Sep, 2020
On 28 Sep, 2020
Posted 30 Apr, 2020
On 01 Sep, 2020
Received 25 Aug, 2020
On 07 Aug, 2020
On 05 Aug, 2020
Received 05 Aug, 2020
Received 03 Jun, 2020
On 16 May, 2020
Invitations sent on 13 May, 2020
On 21 Apr, 2020
On 20 Apr, 2020
On 20 Apr, 2020
On 19 Apr, 2020
Background: Ulnar shortening osteotomy (USO) is an effective treatment for the ulnar impaction syndrome. But there has been a concern of osteoarthritis developing in the distal radioulnar joint (DRUJ) if we perform the USO in patients with reverse oblique sigmoid notch. This study was to evaluate the radiographic and functional outcomes following USO in patients with reverse oblique sigmoid notch.
Methods: Between 2002 and 2013, we retrospectively reviewed our patients with reverse oblique sigmoid notch underwent USO in treating the ulnar impaction syndrome. We evaluated the radiographic changes in the DRUJ and their functional outcomes.
Results: We enrolled 22 patients (22 wrists) with an average age at operation of 49.6 years and mean follow-up of 93.2 months. We found that there were changes in the inclination angle of sigmoid notch, from an average of reverse oblique 14.9o preoperatively to a more parallel of 5.1o at the final follow-ups. The functional results at the final follow-ups were good with the mean VAS for pain of 0.3 at rest and 1.4 during activity, QuickDASH of 16.5, and modified Mayo Wrist Score of 91.4. There were 7 wrists (31.8%) noted to have osteoarthritic change, but they did not exhibit significantly worse function, except supination motion, pain during activity, and grip strength.
Conclusions For the patients with reverse oblique sigmoid inclination following USO, the inclination angle would have a tendency to become more parallel and some would develop the osteoarthritic change in the DRUJ, but the functional outcomes could still be good in the intermediate and long-term. The reverse oblique sigmoid inclination seems not to be an absolute contraindication for USO.

Figure 1
Loading...