{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T21:53:12Z","timestamp":1785880392558,"version":"3.56.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T00:00:00Z","timestamp":1657065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T00:00:00Z","timestamp":1657065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Positive ulnar variance following a distal radius malunion can lead to ulnar-sided wrist pain, loss of grip strength, and distal radioulnar joint impingement. The primary aim of this study is to describe upper limb-specific functional outcomes following ulnar shortening osteotomy (USO) for ulnar-sided wrist pain associated with malunion of the distal radius.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrospectively identified 40 adult patients from a single centre over a 9-year period that had undergone an USO for symptomatic malunion of the distal radius. The primary outcome was the patient-rated wrist evaluation (PRWE). Secondary outcomes were the QuickDASH, EQ-5D-5L, complications, and net promoter score (NPS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Outcomes were available for 37 patients (93%). The mean age was 56\u00a0years and 25 patients were female (68%). At a mean follow-up of 6\u00a0years (range 1\u201310\u00a0years) the median PRWE was 11 (IQR 0\u201329.5), the median QuickDASH 6.8 (IQR 0\u201329.5), and the median EQ-5D-5L index was 0.88 (IQR 0.71\u20131). The NPS was 73. Complications occurred in nine patients (24%) and included non-union (<jats:italic>n<\/jats:italic>\u2009=\u20094), early loss of fixation requiring revision surgery (<jats:italic>n<\/jats:italic>\u2009=\u20091), superficial wound infection (<jats:italic>n<\/jats:italic>\u2009=\u20092), neurological injury (<jats:italic>n<\/jats:italic>\u2009=\u20091), and further surgery for symptomatic hardware removal (<jats:italic>n<\/jats:italic>\u2009=\u20091).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>For patients with a symptomatic distal radius malunion where the predominant deformity is ulnar positive variance, this study has demonstrated that despite 1 in 4 patients experiencing a complication, USO can result in excellent patient reported outcomes with high levels of satisfaction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of Evidence<\/jats:title>\n                <jats:p> III (Cohort Study).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00590-022-03325-9","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:31:15Z","timestamp":1657153875000},"page":"1635-1640","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Distal radius malunion: outcomes following an ulnar shortening osteotomy"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3857-8628","authenticated-orcid":false,"given":"Paul H. C.","family":"Stirling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Oliver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W.","family":"Oliver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret M.","family":"McQueen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel G.","family":"Molyneux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Duckworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"key":"3325_CR1","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/J.JHSB.2006.11.010","volume":"32","author":"T Barton","year":"2007","unstructured":"Barton T, Chamber C, Bannister G (2007) A comparison between subjective outcome score and moderate radial shortening following a fractured distal radius in patients of mean age 69 years. J Hand Surg Eur 32:165\u2013169","journal-title":"J Hand Surg Eur"},{"key":"3325_CR2","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1097\/00003086-198407000-00005","volume":"187","author":"A Palmer","year":"1984","unstructured":"Palmer A, Werner F (1984) Biomechanics of the distal radioulnar joint. Clin Orthop Relat Res 187:26\u201335","journal-title":"Clin Orthop Relat Res"},{"key":"3325_CR3","doi-asserted-by":"publisher","first-page":"1919","DOI":"10.1016\/j.jhsa.2013.06.038","volume":"38","author":"JA Greenberg","year":"2013","unstructured":"Greenberg JA, Werner FW, Smith JM (2013) Biomechanical analysis of the distal metaphyseal ulnar shortening osteotomy. J Hand Surg Am 38:1919\u20131924. https:\/\/doi.org\/10.1016\/j.jhsa.2013.06.038","journal-title":"J Hand Surg Am"},{"key":"3325_CR4","first-page":"239","volume":"69","author":"N Hollevoet","year":"2003","unstructured":"Hollevoet N, Verdonk R (2003) The functional importance of malunion in distal radius fractures. Acta Orthop Belg 69:239\u2013245","journal-title":"Acta Orthop Belg"},{"key":"3325_CR5","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1302\/0301-620x.70b4.3403617","volume":"70","author":"M McQueen","year":"1988","unstructured":"McQueen M, Caspers J (1988) Colles fracture: Does the anatomical result affect the final function? J Bone Jt Surg B 70:649\u2013651. https:\/\/doi.org\/10.1302\/0301-620x.70b4.3403617","journal-title":"J Bone Jt Surg B"},{"key":"3325_CR6","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1302\/0301-620X.102B11.BJJ-2020-0848.R3","volume":"102-B","author":"PHC Stirling","year":"2020","unstructured":"Stirling PHC, Oliver WM, Ling Tan H et al (2020) Patient-reported outcomes after corrective osteotomy for a symptomatic malunion of the distal radius. Bone Jt J 102-B:1542\u20131548. https:\/\/doi.org\/10.1302\/0301-620X.102B11.BJJ-2020-0848.R3","journal-title":"Bone Jt J"},{"key":"3325_CR7","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1177\/1753193417745259","volume":"43","author":"PA Liverneaux","year":"2018","unstructured":"Liverneaux PA (2018) The minimally invasive approach for distal radius fractures and malunions. J Hand Surg Eur 43:121\u2013130. https:\/\/doi.org\/10.1177\/1753193417745259","journal-title":"J Hand Surg Eur"},{"key":"3325_CR8","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1055\/s-0034-1384747","volume":"03","author":"R Kamal","year":"2014","unstructured":"Kamal R, Leversedge F (2014) Ulnar shortening osteotomy for distal radius malunion. J Wrist Surg 03:181\u2013186. https:\/\/doi.org\/10.1055\/s-0034-1384747","journal-title":"J Wrist Surg"},{"key":"3325_CR9","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1177\/1558944716685831","volume":"13","author":"WR Aibinder","year":"2018","unstructured":"Aibinder WR, Izadpanah A, Elhassan BT (2018) Ulnar shortening versus distal radius corrective osteotomy in the management of ulnar impaction after distal radius malunion. Hand 13:194\u2013201. https:\/\/doi.org\/10.1177\/1558944716685831","journal-title":"Hand"},{"key":"3325_CR10","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1007\/BF00662289","volume":"112","author":"J Oskam","year":"1993","unstructured":"Oskam J, Kingma J, Klasen H (1993) Ulnar-shortening osteotomy after fracture of the distal radius. Arch Orthop Trauma Surg 112:198\u2013200","journal-title":"Arch Orthop Trauma Surg"},{"key":"3325_CR11","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1007\/BF00434545","volume":"115","author":"R Fricker","year":"1996","unstructured":"Fricker R, Pfeiffer K, Troeger H (1996) Ulnar shortening osteotomy in posttraumatic ulnar impaction syndrome. Arch Orthop Trauma Surg 115:158\u2013161","journal-title":"Arch Orthop Trauma Surg"},{"key":"3325_CR12","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1308\/rcsann.2018.0211","volume":"101","author":"S Hassan","year":"2019","unstructured":"Hassan S, Shafafy R, Mohan A, Magnussen P (2019) Solitary ulnar shortening osteotomy for malunion of distal radius fractures: experience of a centre in the UK and review of the literature. Ann R Coll Surg Engl 101:203\u2013207","journal-title":"Ann R Coll Surg Engl"},{"key":"3325_CR13","first-page":"464","volume":"85","author":"J Declerq","year":"2019","unstructured":"Declerq J, Vanhove W, Benis S, Hollevoet N (2019) Results of ulnar shortening osteotomy in patients with ulnar wrist pain. A retrospective study. Acta Orthop Belg 85:464\u2013471","journal-title":"Acta Orthop Belg"},{"key":"3325_CR14","first-page":"317","volume":"78","author":"A Cherchel","year":"2012","unstructured":"Cherchel A, Vandendungen S, Moermans J, Ledoux P (2012) Ulna-shortening osteotomy: subjective appreciation and long-term functional outcome. Acta Orthop Belg 78:317\u2013323","journal-title":"Acta Orthop Belg"},{"key":"3325_CR15","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001760","volume":"6","author":"F Gilbert","year":"2018","unstructured":"Gilbert F, Jakubietz R, Meffert R, Jakubietz M (2018) Does distal radio-ulnar joint configuration affect postoperative functional results after ulnar shortening osteotomy? Plast Reconstr Surg Glob Open 6:e1760","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"3325_CR16","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s00402-013-1892-5","volume":"134","author":"S L\u00f6w","year":"2014","unstructured":"L\u00f6w S, M\u00fchldorfer-Fodor M, Pillukat T et al (2014) Ulnar shortening osteotomy for malunited distal radius fractures: results of a 7-year follow-up with special regard to the grade of radial displacement and post-operative ulnar variance. Arch Orthop Trauma Surg 134:131\u2013137","journal-title":"Arch Orthop Trauma Surg"},{"key":"3325_CR17","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1016\/j.jhsa.2013.03.015","volume":"38","author":"R Srinivasan","year":"2013","unstructured":"Srinivasan R, Jain D, Richard M et al (2013) Isolated ulnar shortening osteotomy for the treatment of extra-articular distal radius malunion. J Hand Surg Am 38:1106\u20131110","journal-title":"J Hand Surg Am"},{"key":"3325_CR18","first-page":"714","volume":"78","author":"M Tatebe","year":"2012","unstructured":"Tatebe M, Shinohara T, Okui N et al (2012) Results of ulnar shortening osteotomy for ulnocarpal abutment after malunited distal radius fracture. Acta Orthop Belg 78:714\u2013718","journal-title":"Acta Orthop Belg"},{"key":"3325_CR19","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1097\/BOT.0000000000001063","volume":"32","author":"EG Meinberg","year":"2018","unstructured":"Meinberg EG, Agel J, Roberts CS et al (2018) Fracture and dislocation classification compendium-2018. J Orthop Trauma 32:S1\u2013S170. https:\/\/doi.org\/10.1097\/BOT.0000000000001063","journal-title":"J Orthop Trauma"},{"key":"3325_CR20","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/S0894-1130(96)80076-7","volume":"9","author":"JC MacDermid","year":"1996","unstructured":"MacDermid JC (1996) Development of a scale for patient rating of wrist pain and disability. J Hand Ther 9:178\u2013183. https:\/\/doi.org\/10.1016\/S0894-1130(96)80076-7","journal-title":"J Hand Ther"},{"key":"3325_CR21","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.2106\/JBJS.D.02060","volume":"87","author":"DE Beaton","year":"2005","unstructured":"Beaton DE, Wright JG, Katz JN et al (2005) Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Jt Surg A 87:1038\u20131046. https:\/\/doi.org\/10.2106\/JBJS.D.02060","journal-title":"J Bone Jt Surg A"},{"key":"3325_CR22","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1177\/1753193418819686","volume":"44","author":"P Stirling","year":"2019","unstructured":"Stirling P, Jenkins PJ, Clement ND et al (2019) The Net Promoter Scores with Friends and Family Test after four hand surgery procedures. J Hand Surg Eur 44:290\u2013295. https:\/\/doi.org\/10.1177\/1753193418819686","journal-title":"J Hand Surg Eur"},{"key":"3325_CR23","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3109\/07853890109002087","volume":"33","author":"R Rabin","year":"2001","unstructured":"Rabin R, De Charro F (2001) EQ-5D: a measure of health status from the EuroQoL Group. Ann Med 33:337\u2013343. https:\/\/doi.org\/10.3109\/07853890109002087","journal-title":"Ann Med"},{"key":"3325_CR24","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1080\/2000656X.2019.1693392","volume":"54","author":"I Andreasson","year":"2020","unstructured":"Andreasson I, Kjellby-Wendt G, Fagevik-Ols\u00e9n M et al (2020) Long-term outcomes of corrective osteotomy for malunited fractures of the distal radius. J Plast Surg Hand Surg 54:94\u2013100. https:\/\/doi.org\/10.1080\/2000656X.2019.1693392","journal-title":"J Plast Surg Hand Surg"},{"key":"3325_CR25","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1016\/J.INJURY.2017.01.045","volume":"48","author":"MAM Mulders","year":"2017","unstructured":"Mulders MAM, d\u2019Ailly PN, Cleffken BI, Schep NWL (2017) Corrective osteotomy is an effective method of treating distal radius malunions with good long-term functional results. Injury 48:731\u2013737. https:\/\/doi.org\/10.1016\/J.INJURY.2017.01.045","journal-title":"Injury"},{"key":"3325_CR26","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1177\/1753193409357373","volume":"35","author":"SA Lozano-Calder\u00f3n","year":"2010","unstructured":"Lozano-Calder\u00f3n SA, Brouwer KM, Doornberg JN et al (2010) Long-term outcomes of corrective osteotomy for the treatment of distal radius malunion. J Hand Surg Eur 35:370\u2013380. https:\/\/doi.org\/10.1177\/1753193409357373","journal-title":"J Hand Surg Eur"},{"key":"3325_CR27","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1016\/j.jhsa.2004.07.002","volume":"29","author":"A Anzarut","year":"2004","unstructured":"Anzarut A, Johnson JA, Rowe BH et al (2004) Radiologic and patient-reported functional outcomes in an elderly cohort with conservatively treated distal radius fractures. J Hand Surg Am 29:1121\u20131127. https:\/\/doi.org\/10.1016\/j.jhsa.2004.07.002","journal-title":"J Hand Surg Am"},{"key":"3325_CR28","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.crad.2006.08.013","volume":"62","author":"JL Jaremko","year":"2007","unstructured":"Jaremko JL, Lambert RGW, Rowe BH et al (2007) Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment? Clin Radiol 62:65\u201372. https:\/\/doi.org\/10.1016\/j.crad.2006.08.013","journal-title":"Clin Radiol"},{"key":"3325_CR29","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1002\/jbm.b.31524","volume":"92","author":"A Abramo","year":"2010","unstructured":"Abramo A, Geijer M, Kopylov P, T\u00e4gil M (2010) Clinical device-related article osteotomy of distal radius fracture malunion using a fast remodeling bone substitute consisting of calcium sulphate and calcium phosphate. J Biomed Mater Res B 92:281\u2013286. https:\/\/doi.org\/10.1002\/jbm.b.31524","journal-title":"J Biomed Mater Res B"},{"key":"3325_CR30","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1053\/jhsu.2000.jhsu025a0019","volume":"25","author":"BT Young","year":"2000","unstructured":"Young BT, Rayan GM (2000) Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years. J Hand Surg Am 25:19\u201328. https:\/\/doi.org\/10.1053\/jhsu.2000.jhsu025a0019","journal-title":"J Hand Surg Am"},{"key":"3325_CR31","doi-asserted-by":"publisher","first-page":"612.e1","DOI":"10.1016\/j.jhsa.2018.08.018","volume":"44","author":"J Owens","year":"2019","unstructured":"Owens J, Compton J, Day M et al (2019) Nonunion rates among ulnar-shortening osteotomy for ulnar impaction syndrome: a systematic review. J Hand Surg Am 44:612.e1\u201312","journal-title":"J Hand Surg Am"},{"key":"3325_CR32","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1302\/0301-620x.84b7.0840967","volume":"84-B","author":"IA Karnezis","year":"2002","unstructured":"Karnezis IA, Fragkiadakis EG (2002) Association between objective clinical variables and patient-rated disability of the wrist. J Bone Jt Surg Br 84-B:967\u2013970. https:\/\/doi.org\/10.1302\/0301-620x.84b7.0840967","journal-title":"J Bone Jt Surg Br"}],"container-title":["European Journal of Orthopaedic Surgery &amp; Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-022-03325-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00590-022-03325-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-022-03325-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T13:05:26Z","timestamp":1686920726000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00590-022-03325-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,6]]},"references-count":32,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["3325"],"URL":"https:\/\/doi.org\/10.1007\/s00590-022-03325-9","relation":{},"ISSN":["1432-1068"],"issn-type":[{"value":"1432-1068","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,6]]},"assertion":[{"value":"8 March 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human or animal subjects.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human and animal rights statement"}},{"value":"This manuscript does not contain any patient identifiable information","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}