To compare the efficacy of ulna "Z"-shaped osteotomy combined with (or without) arthroscopic suture anchor TFCC deep repair in the treatment of ulnar impact syndrome with moderate to severe distal radioulnar joint instability.
A retrospective analysis was conducted on the clinical data of 30 patients with ulnar impact syndrome and moderate to severe distal radioulnar joint instability. Among them, 15 patients underwent ulna "Z"-shaped osteotomy alone (osteotomy group), and the other 15 patients underwent ulna "Z"-shaped osteotomy combined with arthroscopic suture anchor TFCC deep repair (combined group). The operation time, blood loss, and length of ulna osteotomy were compared between the two groups. Preoperative and intraoperative ulnar variance, forearm rotation, ulnar-radial deviation, palmar-dorsal flexion angle, grip strength, visual analog scale (VAS), patient-rated wrist evaluation (PRWE) score, modified Mayo wrist score, and disabilities of the arm, shoulder, and hand (DASH) score were evaluated preoperatively and postoperatively. Postoperative complication rates were also recorded.
There were no statistically significant differences in intraoperative blood loss and length of ulna osteotomy between the two groups, but the operation time was longer in the combined group. There were no significant differences in intraoperative ulnar variance between the two groups, but both were lower than that before surgery. Postoperatively, the combined group showed better forearm rotation, ulnar-radial deviation, palmar-dorsal flexion angle, VAS, PRWE score, DASH score, modified Mayo wrist score, and grip strength at multiple follow-up time points compared to the osteotomy group, with a lower rate of postoperative complications.
The combination of ulna "Z"-shaped shortening osteotomy and arthroscopic suture anchor TFCC deep repair in the treatment of ulnar impact syndrome with moderate to severe distal radioulnar joint instability can improve wrist range of motion, pain relief, and functional recovery, with a low complication rate.
