Does Distal Radio-ulnar Joint Configuration Affect Postoperative Functional Results after Ulnar Shortening Osteotomy?
Background:. Reverse oblique distal radio-ulnar joint (DRUJ) configuration is assumed to show inferior postoperative results in ulnar-shortening osteotomy due to osteoarthritis, as the joint force pressure in the DRUJ may be increased. An evaluation and comparison of the postoperative functional res...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2018-04-01
|
| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001760 |
| _version_ | 1828763160611389440 |
|---|---|
| author | Fabian Gilbert, MD Rafael G. Jakubietz, MD Rainer H. Meffert, MD Michael G. Jakubietz, Priv- Doz, MD |
| author_facet | Fabian Gilbert, MD Rafael G. Jakubietz, MD Rainer H. Meffert, MD Michael G. Jakubietz, Priv- Doz, MD |
| author_sort | Fabian Gilbert, MD |
| collection | DOAJ |
| description | Background:. Reverse oblique distal radio-ulnar joint (DRUJ) configuration is assumed to show inferior postoperative results in ulnar-shortening osteotomy due to osteoarthritis, as the joint force pressure in the DRUJ may be increased. An evaluation and comparison of the postoperative functional results with regard to clinical and radiographic signs of arthritis among different DRUJ configurations was carried out retrospectively.
Methods:. Sixty-two patients after ulnar shortening osteotomy were included. The minimum follow-up was 5 years. Preoperative x-rays were assessed for the DRUJ configuration according to the Tolat classification, whereas postoperative radiographs were evaluated with regard to signs of osteoarthritis using the Kallgren-Lawrence-Score. Functional results were evaluated using the disabilities of the arm, shoulder and hand (DASH) and Mayo Wrist Score and measuring range of motion and grip strength.
Results:. Significantly better functional results were found in patients with parallel configuration of the DRUJ (Tolat type 1 configuration) with regard to DASH score, grip strength, and supination compared with nonparallel configurations. In the Tolat type 1, configurated DRUJ mean DASH score was 9 compared with 18 in the Tolat type 2 and 3 groups. Apart from supination, no differences were observed in range of motion among groups.
Conclusion:. Although long-term postoperative range of motion failed to display statistically significant differences between DRUJ configurations except for supination, better results regarding grip strength and DASH scores were seen in a parallel-aligned DRUJ configuration. Although onset of osteoarthritis does not seem to become apparent within the observation period, nonparallel aligned configuration predisposes to inferior results. |
| first_indexed | 2024-12-11T01:56:21Z |
| format | Article |
| id | doaj.art-105d720c97da478a9a24909a0a3787fd |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-11T01:56:21Z |
| publishDate | 2018-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-105d720c97da478a9a24909a0a3787fd2022-12-22T01:24:37ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742018-04-0164e176010.1097/GOX.0000000000001760201804000-00008Does Distal Radio-ulnar Joint Configuration Affect Postoperative Functional Results after Ulnar Shortening Osteotomy?Fabian Gilbert, MD0Rafael G. Jakubietz, MD1Rainer H. Meffert, MD2Michael G. Jakubietz, Priv- Doz, MD3From the Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Wuerzburg, Wuerzburg, Germany.From the Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Wuerzburg, Wuerzburg, Germany.From the Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Wuerzburg, Wuerzburg, Germany.From the Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Wuerzburg, Wuerzburg, Germany.Background:. Reverse oblique distal radio-ulnar joint (DRUJ) configuration is assumed to show inferior postoperative results in ulnar-shortening osteotomy due to osteoarthritis, as the joint force pressure in the DRUJ may be increased. An evaluation and comparison of the postoperative functional results with regard to clinical and radiographic signs of arthritis among different DRUJ configurations was carried out retrospectively. Methods:. Sixty-two patients after ulnar shortening osteotomy were included. The minimum follow-up was 5 years. Preoperative x-rays were assessed for the DRUJ configuration according to the Tolat classification, whereas postoperative radiographs were evaluated with regard to signs of osteoarthritis using the Kallgren-Lawrence-Score. Functional results were evaluated using the disabilities of the arm, shoulder and hand (DASH) and Mayo Wrist Score and measuring range of motion and grip strength. Results:. Significantly better functional results were found in patients with parallel configuration of the DRUJ (Tolat type 1 configuration) with regard to DASH score, grip strength, and supination compared with nonparallel configurations. In the Tolat type 1, configurated DRUJ mean DASH score was 9 compared with 18 in the Tolat type 2 and 3 groups. Apart from supination, no differences were observed in range of motion among groups. Conclusion:. Although long-term postoperative range of motion failed to display statistically significant differences between DRUJ configurations except for supination, better results regarding grip strength and DASH scores were seen in a parallel-aligned DRUJ configuration. Although onset of osteoarthritis does not seem to become apparent within the observation period, nonparallel aligned configuration predisposes to inferior results.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001760 |
| spellingShingle | Fabian Gilbert, MD Rafael G. Jakubietz, MD Rainer H. Meffert, MD Michael G. Jakubietz, Priv- Doz, MD Does Distal Radio-ulnar Joint Configuration Affect Postoperative Functional Results after Ulnar Shortening Osteotomy? Plastic and Reconstructive Surgery, Global Open |
| title | Does Distal Radio-ulnar Joint Configuration Affect Postoperative Functional Results after Ulnar Shortening Osteotomy? |
| title_full | Does Distal Radio-ulnar Joint Configuration Affect Postoperative Functional Results after Ulnar Shortening Osteotomy? |
| title_fullStr | Does Distal Radio-ulnar Joint Configuration Affect Postoperative Functional Results after Ulnar Shortening Osteotomy? |
| title_full_unstemmed | Does Distal Radio-ulnar Joint Configuration Affect Postoperative Functional Results after Ulnar Shortening Osteotomy? |
| title_short | Does Distal Radio-ulnar Joint Configuration Affect Postoperative Functional Results after Ulnar Shortening Osteotomy? |
| title_sort | does distal radio ulnar joint configuration affect postoperative functional results after ulnar shortening osteotomy |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001760 |
| work_keys_str_mv | AT fabiangilbertmd doesdistalradioulnarjointconfigurationaffectpostoperativefunctionalresultsafterulnarshorteningosteotomy AT rafaelgjakubietzmd doesdistalradioulnarjointconfigurationaffectpostoperativefunctionalresultsafterulnarshorteningosteotomy AT rainerhmeffertmd doesdistalradioulnarjointconfigurationaffectpostoperativefunctionalresultsafterulnarshorteningosteotomy AT michaelgjakubietzprivdozmd doesdistalradioulnarjointconfigurationaffectpostoperativefunctionalresultsafterulnarshorteningosteotomy |