Arthroscopic wafer procedure versus ulnar shortening osteotomy for treatment of ulnar impaction syndrome with a short-term follow-up

Abstract Objectives A prospective study aimed to systematically compare the efficacy and safety of arthroscopic wafer procedure (AWP) versus ulnar shortening osteotomy (USO) for treating ulnar impaction syndrome (UIS) with a short-term follow-up. Methods From May 2014 to January 2022, 94 patients diagnosed with UIS were recruited and categorized into the AWP and USO groups. At the follow-up, operative time, intraoperative blood loss, hospital length of stay (LOS), and complications were reported. Additionally, clinical evaluation included the visual analog scale (VAS), grip strength, wrist range of motion, and the Modified Mayo Wrist Score (MMWS) were measured at 1, 3, 6, and 12 months postoperatively. Results A total of 47 patients in the AWP group and 44 patients in the USO group completed the follow-up. Patients in the AWP group exhibited significantly reduced operative time, intraoperative blood loss, and LOS than the USO group; however, the complication rates were comparable. Moreover, patients who underwent the AWP procedure exhibited lower VAS and better outcomes regarding grip strength, wrist range of motion, and the MMWS than those who underwent the USO procedure at one and three months postoperatively. However, no statistically significant differences were observed in the two groups at 6 and 12 months postoperatively. Conclusions Although the subsequent safety and efficacy of the two techniques are comparable for UIS treatment, the AWP procedure should be a superior alternative for less invasive and faster recovery. Ulnar variation larger than 4 mm is more suitable for ulnar osteotomy.