What are the long-term effects of Alnar shortening osteotomy?

What are the long-term effects of Alnar shortening osteotomy?

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Alna shortening osteotomy is an established treatment for treating patients with Alnar Impairment Syndrome. Previous studies have shown good results based on radiographs and clinical trials, but there are few studies that evaluate outcomes based on patient satisfaction and quality of life.

Also read: Fixation of 1 or 2 arm bones in pediatric radial and ulna diaphyseal fractures?

Job with Follow up Good work and pain results were seen in 6 months with PRWHE questionnaire (Patient-rated wrist and hand assessment) 106 patients answered after Alnar shortening osteotomy, however, data on these long-term results are very limited. It was published in the magazine last month Open the bones and joints A study aimed at examining such results Follow up The larger secondary objectives were to evaluate the satisfaction of the procedure, complications, and need for further surgery.

What are the long-term consequences of Alnar shortening osteotomy?


A prospective group study was developed with 106 patients from some Dutch hospitals operating between 2011 and 2017. All osteotomies were oblique, performed at the level of the distal diaphysis, and performed by free hand or external cutting instrument, as the surgeon chooses. And was. Ulnar effect as an indication. The average shortening was 4 mm and was based on preoperative Alnar variation. The ulna was fixed by compression plate and screw or with a special system for ulna.

Age, gender, type of work, duration of symptoms, side of treatment, hand dominance during surgery, and smoking were reported regularly. The chart was reviewed to collect data on initial injury, operative variables, complications, and subsequent treatment. Patients also received the Dutch version of PRWHE to evaluate surgical outcomes.

Long-term results were available in 66 patients (74%) after a six-year late follow-up (SD = 1). The average total PRWHE score improved from 63 before surgery to 19 on late follow-up (i.e. difference (Δ) 44; 95% confidence interval (CI) 39 to 50; p = <0.001). During the 12-month and subsequent follow-up, the overall PRWHE score also improved (Δ 12; 95% CI 6 to 18; p = <0.001).

Learn more: Surgical treatment of ulnar fracture of the distal third of the humerus?

On subsequent follow-up, 14/66 patients (21%) reported a total PRWHE score of zero, while at 12 months (p = 0.039) it was 3/51 patients (6%). Overall, 58/66 patients (88%) will receive the same treatment again in the same condition. Subsequent treatment (total n = 66; surgical n = 57) was performed in 50/66 patients (76%) for complications or recurrent symptoms. The most common types of reoperation were found in 42/66 (64%) hardware removal and pseudarthrosis in 8/66 (12%).


Ulna shortening osteotomy also improved the patient’s reported pain and function over a long period of time. Although the level of satisfaction is usually high, reoperation such as hardware removal is common. In addition, it is also important to note that for hair less than Ulana Plus 4mm, the arthroscopic wafer procedure is also a great option for these patients, as well as better results and less complications.


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# Teunissen JS, van der Oest MJW, Selles RW, Ulrich DJO, Hovius SER, van der Heijden B; Hand wrist study group contributors. Long-term outcome after Alna shortening osteotomy: Six-year average follow-up. Bone Jati Open. May 2022; 3 (5): 375-382. doi: 10.1302 / 2633-1462.35.BJO-2022-0031.R1.

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