Abstract
Objective
Retrospective study to assess the outcomes of ulnar shortening for TFCC tear and distal radial malunion.
Method
Retrospective note and x-ray review of all patients undergoing ulnar shortening over a ten year period along with a clinic assessment and scoring to date. The ulnar shortening was performed using the Stanley Jigs (Osteotec). A 5–6 holed DCP was used to stabilize the osteotomy site. Physiotherapy was commenced immediately following the surgery to promote prono-supination and wrist exercises.
Result
28 patients studied with one subsequent death. 13 patients with an average age of 53 years underwent ulnar shortening for distal radius malunion, whereas 15 pateints with an average age of 47 years had a primary indication of ulnar abutment with TFCC tear. Six patients underwent reoperation for non-union. 2 patients needed plate removal for prominent metalware. Patients undergoing the procedure for TFCC deficiency compared to radial malunion did worse, on functional scoring (DASH & SF36). Failure to place an interfragmentary screw was associated with a higher risk of non-union.
Conclusion
Ulnar shortening is not a benign procedure, especially for the treatment of TFCC insufficiency. Interfragmentary screw placement is important in avoiding non-union.
