# Effectiveness of Modified Ulnar Metaphyseal Wedge Osteotomy in Treating Ulnar Impaction Syndrome: A Comparative Clinical Study

## TL;DR

A modified ulnar osteotomy technique shows better recovery and less surgical trauma than traditional methods for treating ulnar impaction syndrome.

## Contribution

Introduces a modified ulnar metaphyseal wedge osteotomy with improved functional outcomes and reduced surgical trauma.

## Key findings

- Modified ulnar metaphyseal wedge osteotomy improved pain and wrist function significantly compared to traditional methods.
- The modified technique resulted in less ulnar shortening, shorter surgery time, and reduced blood loss.
- Patients had fewer implant removals and greater functional improvement with the modified osteotomy.

## Abstract

Ulnar shortening osteotomy (USO) is a standard surgical treatment for ulnar impaction syndrome. This study introduces a modified ulnar metaphyseal wedge osteotomy (MUMWO) and compares its outcomes with conventional diaphyseal ulnar shortening osteotomy (DUSO).

In this retrospective cohort study, we compared postoperative functional outcomes and operative characteristics between patients undergoing traditional diaphyseal ulnar shortening osteotomy (n=18) and those receiving our modified ulnar metaphyseal wedge osteotomy (n=13) for treatment of ulnar impaction syndrome.

No differences were observed in patients characteriscs, ulnar variance, pain and functional score between two groups at the baseline. Patients underwent modified ulnar metaphyseal wedge osteotomy showed significant improvements in pain, Quick-DASH scores, wrist extension, wrist flexion, supination, and pronation (All P≤ 0.001). Compared to diaphyseal ulnar shortening osteotomy, modified ulnar metaphyseal wedge osteotomy was associated with less degree of ulnar shortening, shorter surgery time, and reduced intraoperative blood loss (All P < 0.05). After adequate follow-up time, modified ulnar metaphyseal wedge osteotomyshowed lower rate to remove implants, greater improvement in pain and Quick-Disability of the Arm, Shoulder, and Hand questionnaire scores (Both P<0.001).

Modified ulnar metaphyseal wedge osteotomy of the ulnar shaft and epiphysis optimizes the osteotomy plane and angle, allowing for precise decompression while preserving sufficient bone mass. These biomechanical advantages contribute to better early functional recovery and reduced surgical trauma. However, its potential role in delaying DRUJ degeneration and other complications requires further validation through more large-scale, randomized clinical trials.