Isolated lunotriquetral ligament tears treated with ulnar shortening osteotomy

Ather Mirza, Justin B. Mirza, Alexander Y. Shin, Daniel J. Lorenzana, Brian K. Lee, Brett Izzo

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: To evaluate outcomes in a single-surgeon series of ulnar shortening osteotomy for the treatment of traumatic isolated tears to the lunotriquetral interosseous ligament (LTIL). Methods: This study includes 53 consecutive cases of posttraumatic isolated LTIL tears treated with ulnar shortening osteotomy with minimum 1-year follow-up (range, 1.0-10.6 y). We confirmed all LTIL tears via arthroscopy before performing a precision 2.5-mm oblique osteotomy using a modified Rayhack technique. We assessed outcomes using grip strength measurements and Chun and Palmer's modified Gartland Werley wrist scoring system, which includes subjective and objective outcome measures. Results: Preoperatively, 45 cases were graded as fair (28%; n = 15) or poor (57%; n = 30) on the modified Gartland Werley score. There were insufficient data to calculate grades in 8 cases (15%). At final follow-up, most patients exhibited excellent (51%; n = 27) or good (32%; n = 17) scores, some scored fair (17%; n = 9), and none scored as poor. All subjective and objective variables significantly improved over a mean follow-up of 36 months (range, 12-127 mo). Mean grip strength increased from a value of 23 kg before surgery to 33 kg over the same period, a 41% increase. All patients achieved clinical and radiographic union by 10 months. Osteotomy plates were removed routinely in most cases (89%; n = 47) at a mean of 17 months. Conclusions: Ulnar shortening osteotomy reduced symptoms of posttraumatic isolated LTIL tears in this single-surgeon series. Type of study/level of evidence: Therapeutic IV.

Original languageEnglish (US)
Pages (from-to)1492-1497
Number of pages6
JournalJournal of Hand Surgery
Volume38
Issue number8
DOIs
StatePublished - Aug 2013

Fingerprint

Osteotomy
Ligaments
Tears
Hand Strength
Arthroscopy
Wrist
Outcome Assessment (Health Care)
Therapeutics
Surgeons

Keywords

  • instability
  • ligament
  • Lunotriquetral
  • ulnar shortening osteotomy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Isolated lunotriquetral ligament tears treated with ulnar shortening osteotomy. / Mirza, Ather; Mirza, Justin B.; Shin, Alexander Y.; Lorenzana, Daniel J.; Lee, Brian K.; Izzo, Brett.

In: Journal of Hand Surgery, Vol. 38, No. 8, 08.2013, p. 1492-1497.

Research output: Contribution to journalArticle

Mirza, Ather ; Mirza, Justin B. ; Shin, Alexander Y. ; Lorenzana, Daniel J. ; Lee, Brian K. ; Izzo, Brett. / Isolated lunotriquetral ligament tears treated with ulnar shortening osteotomy. In: Journal of Hand Surgery. 2013 ; Vol. 38, No. 8. pp. 1492-1497.
@article{22a57891674d4a97936e8d76a7397249,
title = "Isolated lunotriquetral ligament tears treated with ulnar shortening osteotomy",
abstract = "Purpose: To evaluate outcomes in a single-surgeon series of ulnar shortening osteotomy for the treatment of traumatic isolated tears to the lunotriquetral interosseous ligament (LTIL). Methods: This study includes 53 consecutive cases of posttraumatic isolated LTIL tears treated with ulnar shortening osteotomy with minimum 1-year follow-up (range, 1.0-10.6 y). We confirmed all LTIL tears via arthroscopy before performing a precision 2.5-mm oblique osteotomy using a modified Rayhack technique. We assessed outcomes using grip strength measurements and Chun and Palmer's modified Gartland Werley wrist scoring system, which includes subjective and objective outcome measures. Results: Preoperatively, 45 cases were graded as fair (28{\%}; n = 15) or poor (57{\%}; n = 30) on the modified Gartland Werley score. There were insufficient data to calculate grades in 8 cases (15{\%}). At final follow-up, most patients exhibited excellent (51{\%}; n = 27) or good (32{\%}; n = 17) scores, some scored fair (17{\%}; n = 9), and none scored as poor. All subjective and objective variables significantly improved over a mean follow-up of 36 months (range, 12-127 mo). Mean grip strength increased from a value of 23 kg before surgery to 33 kg over the same period, a 41{\%} increase. All patients achieved clinical and radiographic union by 10 months. Osteotomy plates were removed routinely in most cases (89{\%}; n = 47) at a mean of 17 months. Conclusions: Ulnar shortening osteotomy reduced symptoms of posttraumatic isolated LTIL tears in this single-surgeon series. Type of study/level of evidence: Therapeutic IV.",
keywords = "instability, ligament, Lunotriquetral, ulnar shortening osteotomy",
author = "Ather Mirza and Mirza, {Justin B.} and Shin, {Alexander Y.} and Lorenzana, {Daniel J.} and Lee, {Brian K.} and Brett Izzo",
year = "2013",
month = "8",
doi = "10.1016/j.jhsa.2013.05.024",
language = "English (US)",
volume = "38",
pages = "1492--1497",
journal = "Journal of Hand Surgery",
issn = "0266-7681",
publisher = "W.B. Saunders Ltd",
number = "8",

}

TY - JOUR

T1 - Isolated lunotriquetral ligament tears treated with ulnar shortening osteotomy

AU - Mirza, Ather

AU - Mirza, Justin B.

AU - Shin, Alexander Y.

AU - Lorenzana, Daniel J.

AU - Lee, Brian K.

AU - Izzo, Brett

PY - 2013/8

Y1 - 2013/8

N2 - Purpose: To evaluate outcomes in a single-surgeon series of ulnar shortening osteotomy for the treatment of traumatic isolated tears to the lunotriquetral interosseous ligament (LTIL). Methods: This study includes 53 consecutive cases of posttraumatic isolated LTIL tears treated with ulnar shortening osteotomy with minimum 1-year follow-up (range, 1.0-10.6 y). We confirmed all LTIL tears via arthroscopy before performing a precision 2.5-mm oblique osteotomy using a modified Rayhack technique. We assessed outcomes using grip strength measurements and Chun and Palmer's modified Gartland Werley wrist scoring system, which includes subjective and objective outcome measures. Results: Preoperatively, 45 cases were graded as fair (28%; n = 15) or poor (57%; n = 30) on the modified Gartland Werley score. There were insufficient data to calculate grades in 8 cases (15%). At final follow-up, most patients exhibited excellent (51%; n = 27) or good (32%; n = 17) scores, some scored fair (17%; n = 9), and none scored as poor. All subjective and objective variables significantly improved over a mean follow-up of 36 months (range, 12-127 mo). Mean grip strength increased from a value of 23 kg before surgery to 33 kg over the same period, a 41% increase. All patients achieved clinical and radiographic union by 10 months. Osteotomy plates were removed routinely in most cases (89%; n = 47) at a mean of 17 months. Conclusions: Ulnar shortening osteotomy reduced symptoms of posttraumatic isolated LTIL tears in this single-surgeon series. Type of study/level of evidence: Therapeutic IV.

AB - Purpose: To evaluate outcomes in a single-surgeon series of ulnar shortening osteotomy for the treatment of traumatic isolated tears to the lunotriquetral interosseous ligament (LTIL). Methods: This study includes 53 consecutive cases of posttraumatic isolated LTIL tears treated with ulnar shortening osteotomy with minimum 1-year follow-up (range, 1.0-10.6 y). We confirmed all LTIL tears via arthroscopy before performing a precision 2.5-mm oblique osteotomy using a modified Rayhack technique. We assessed outcomes using grip strength measurements and Chun and Palmer's modified Gartland Werley wrist scoring system, which includes subjective and objective outcome measures. Results: Preoperatively, 45 cases were graded as fair (28%; n = 15) or poor (57%; n = 30) on the modified Gartland Werley score. There were insufficient data to calculate grades in 8 cases (15%). At final follow-up, most patients exhibited excellent (51%; n = 27) or good (32%; n = 17) scores, some scored fair (17%; n = 9), and none scored as poor. All subjective and objective variables significantly improved over a mean follow-up of 36 months (range, 12-127 mo). Mean grip strength increased from a value of 23 kg before surgery to 33 kg over the same period, a 41% increase. All patients achieved clinical and radiographic union by 10 months. Osteotomy plates were removed routinely in most cases (89%; n = 47) at a mean of 17 months. Conclusions: Ulnar shortening osteotomy reduced symptoms of posttraumatic isolated LTIL tears in this single-surgeon series. Type of study/level of evidence: Therapeutic IV.

KW - instability

KW - ligament

KW - Lunotriquetral

KW - ulnar shortening osteotomy

UR - http://www.scopus.com/inward/record.url?scp=84880906325&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880906325&partnerID=8YFLogxK

U2 - 10.1016/j.jhsa.2013.05.024

DO - 10.1016/j.jhsa.2013.05.024

M3 - Article

C2 - 23849735

AN - SCOPUS:84880906325

VL - 38

SP - 1492

EP - 1497

JO - Journal of Hand Surgery

JF - Journal of Hand Surgery

SN - 0266-7681

IS - 8

ER -