Purpose
Ulnar impaction syndrome is a common cause of ulnar wrist pain. The purpose of this
study was to determine whether there are any differences between ulnar shortening
osteotomy (USO) and the wafer procedure (WP) in terms of clinical outcomes, radiologic
outcome, and postoperative complication rate by means of a systematic literature review
and meta-analysis.
Materials and Methods
MEDLINE, Embase, and the Cochrane Library were searched systematically for studies
published before August 22, 2021, that compared USO and the WP for ulnar impaction
syndrome. The pooled analysis was designed to compare the visual analog scale pain
score, Disabilities of the Arm, Shoulder and Hand score, modified Mayo score, postoperative
ulnar variance, and complication rate between USO and WP.
Results
The initial literature search yielded 72 articles. After applying our inclusion and
exclusion criteria, 5 studies were eligible for the qualitative and quantitative data
syntheses. Surgical indications for performing USO or WP were similar in all patients
with idiopathic ulnar impaction syndrome. There were no significant differences in
the visual analog scale score (P = .73), Disabilities of the Arm, Shoulder and Hand score (P = .09), modified Mayo score (Positive outcome, P = .85/Negative outcome, P = .39), postoperative ulnar variance (P = .29), and complications, other than implant irritation (P = .42), between the USO and WP groups. However, overall complication rate was higher
in patients treated with USO (P < .05).
Conclusions
The WP and USO for idiopathic ulnar impaction syndrome achieve similar clinical and
radiologic outcomes. Although overall complications are significantly more frequent
in patients treated with USO, complications not including implant irritation are similar
in both groups.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: October 28, 2022
Accepted:
August 31,
2022
Received:
February 13,
2022
Publication stage
In Press Corrected ProofFootnotes
Hyoung-Seok Jung and Chul-Ho Kim contributed equally to this manuscript as first authors.
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.