- 作者：Ather Mirza ; Justin B. Mirza ; Alex ; er Y. Shin ; Daniel J. Lorenzana ; Brian K. Lee ; Brett Izzo
- 关键词：Lunotriquetral ; ligament ; instability ; ulnar shortening osteotomy
- 刊名：The Journal of Hand Surgery
- 出版年：2013
- 出版时间：August, 2013
- 年：2013
- 卷：38
- 期：8
- 页码：1492-1497
- 全文大小：580 K
class=""h4"">Purpose
To evaluate outcomes in a single-surgeon series of ulnar shortening osteotomy for the treatment of traumatic isolated tears to the lunotriquetral interosseous ligament (LTIL).class=""h4"">Methods
This study includes 53 consecutive cases of posttraumatic isolated LTIL tears treated with ulnar shortening osteotomy with minimum 1-year follow-up (range, 1.0-10.6 y). We confirmed all LTIL tears via arthroscopy before performing a precision 2.5-mm oblique osteotomy using a modified Rayhack technique. We assessed outcomes using grip strength measurements and Chun and Palmer's modified Gartland Werley wrist scoring system, which includes subjective and objective outcome measures.
class=""h4"">Results
Preoperatively, 45 cases were graded as fair (28 % ; n = 15) or poor (57 % ; n = 30) on the modified Gartland Werley score. There were insufficient data to calculate grades in 8 cases (15 % ). At final follow-up, most patients exhibited excellent (51 % ; n = 27) or good (32 % ; n = 17) scores, some scored fair (17 % ; n = 9), and none scored as poor. All subjective and objective variables significantly improved over a mean follow-up of 36 months (range, 12-127 mo). Mean grip strength increased from a value of 23 kg before surgery to 33 kg over the same period, a 41 % increase. All patients achieved clinical and radiographic union by 10 months. Osteotomy plates were removed routinely in most cases (89 % ; n = 47) at a mean of 17 months.
class=""h4"">Conclusions
Ulnar shortening osteotomy reduced symptoms of posttraumatic isolated LTIL tears in this single-surgeon series.
class=""h4"">Type of study/level of evidence
Therapeutic IV.