{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:54Z","timestamp":1740126834596,"version":"3.37.3"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund 2016 wurde die dekomprimierende Radiuskorrekturosteotomie zur\n                    Behandlung des schmerzhaften Impingement-Syndroms des distalen Radioulnaren\n                    Gelenks (DRUG) erstmals beschrieben. Die Vorstellung der betroffenen Patienten\n                    erfolgt wegen belastungsabh\u00e4ngigen Schmerzen im DRUG, wobei bei der klinischen\n                    Untersuchung ein positiver Kompressionstest im DRUG richtungsweisend ist. Die\n                    Diagnose wird durch den radiologischen Nachweis einer Ulna minus-Varianz mit\n                    Deformierung der Incisura ulnaris best\u00e4tigt. Genese dieser Inkongruenz im DRUG\n                    kann entweder kongenital, posttraumatisch oder iatrogen sein. Durch die\n                    Radiuskorrektur wird ein Remodelling im DRUG erreicht und gleichzeitig\n                    resultiert durch Entspannung der distalen Membrana interossea (DIOM) eine\n                    Druckreduktion. Diese Studie widmet sich der Auswertung der bisher\n                    durchgef\u00fchrten Operationen in unserem Zentrum bei ausschlie\u00dflich kongenitaler\n                    Ursache.<\/jats:p><jats:p>\n          Patienten und Methoden Die Verbesserung der Kongruenz der Gelenkfl\u00e4chen\n                    des DRUG wird durch Radiusverk\u00fcrzung und \u00c4nderung der Neigung der Sigmoid notch\n                    mittels closed wedge Osteotomie erzielt. Die Entspannung der Membrana interossea\n                    erfolgt durch ulnare Translation des Radiusschaftes. Das Patientengut beinhaltet\n                    nur Patientinnen und Patienten mit angeborener Inkongruenz im DRUG. Zur\n                    Auswertung der Ergebnisse benutzten wir die visuelle Analogskala (VAS), pr\u00e4- und\n                    postoperative Messung des Bewegungsumfanges (ROM) in der sagittalen und\n                    transversalen Ebene, Kraftmessung und den Wrist Score nach Krimmer.<\/jats:p><jats:p>\n          Ergebnisse Im Verlauf von 11 Jahren fanden 45 Operationen an 38 Patienten\n                    mit unserer Methode statt, davon bei 17 auf der rechten, bei 14 auf der linken\n                    Seite und 7 Patienten operierten wir bilateral. Bei radiologisch bilateral\n                    nachgewiesener Inkongruenz wurde nur die symptomatische Seite operiert. Die\n                    statistische Evaluation zeigte in der VAS postoperativ eine signifikante\n                    Schmerzlinderung von 7,2 auf 2 (p&lt;0,001). Durch die Osteotomie wurde keine\n                    signifikante \u00c4nderung des Bewegungsausma\u00dfes verursacht (p=0,812). Der Wrist\n                    Score nach Krimmer erbrachte in fast 90% der F\u00e4lle ein gutes bis sehr gutes\n                    Ergebnis.<\/jats:p><jats:p>\n          Schlussfolgerung Bei korrekter Indikationsstellung und Operationstechnik\n                    f\u00fchrt diese Methode zur Verbesserung der Funktionalit\u00e4t und Lebensqualit\u00e4t der\n                    Patienten. Der pr\u00e4ventive Aspekt mit Vermeidung degenerativer Prozesse bleibt\n                    weiteren Studien vorbehalten. Diese Operation gilt als sichere Methode und l\u00e4sst\n                    den Weg f\u00fcr alternative Ma\u00dfnahmen offen.<\/jats:p>","DOI":"10.1055\/a-2319-1047","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T22:59:54Z","timestamp":1720047594000},"page":"17-22","source":"Crossref","is-referenced-by-count":0,"title":["Therapie des kongenitalen ulnaren Impingement-Syndroms durch\n                    dekomprimierende Korrekturosteotomie des distalen Radius \u2013 klinische\n                    Ergebnisse"],"prefix":"10.1055","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7304-5242","authenticated-orcid":false,"given":"Petr","family":"Machac","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Hand- und Fusschirurgie, Krankenhaus St. Elisabeth,\n                    Ravensburg, Germany"},{"name":"Klinik f\u00fcr Traumatologie, Universit\u00e4t Szeged, Szeged,\n                    Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9","family":"Schandl","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Hand- und Fusschirurgie, Krankenhaus St. Elisabeth,\n                    Ravensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Wolters","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Hand- und Fusschirurgie, Krankenhaus St. Elisabeth,\n                    Ravensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hermann","family":"Krimmer","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Hand- und Fusschirurgie, Krankenhaus St. Elisabeth,\n                    Ravensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,7,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1007\/s00132-018-3592-x","article-title":"Die Therapie des Impingementsyndroms im distalen Radioulnargelenk","volume":"47","author":"H Krimmer","year":"2018","journal-title":"Orthop\u00e4de"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s00402-015-2363-y","article-title":"The distal radial decompression osteotomy for ulnar impingement syndrome","volume":"136","author":"H Krimmer","year":"2016","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1016\/0266-7681(92)90200-l","article-title":"The gymnast's wrist: acquired positive ulnar variance following chronic\n                    epiphyseal injury","volume":"17","author":"A R Tolat","year":"1992","journal-title":"J Hand Surg Br"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/s0266-7681(96)80136-7","article-title":"A cadaveric study of the anatomy and stability of the distal radioulnar joint in\n                    the coronal and transverse planes","volume":"21","author":"A R Tolat","year":"1996","journal-title":"J Hand Surg Br"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1055\/s-0040-1713158","article-title":"Morphology at the Distal Radioulnar Joint: Identifying the Prevalence of Reverse\n                    Obliquity","volume":"9","author":"M O'Shaughnessy","year":"2020","journal-title":"J Wrist Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1016\/j.jhsa.2008.10.025","article-title":"Interosseous membrane of the forearm: an anatomical study of ligament attachment\n                    locations","volume":"34","author":"K Noda","year":"2009","journal-title":"J Hand Surg Am"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2022","DOI":"10.2106\/jbjs.J.00411","article-title":"The stabilizing effect of the distal interosseous membrane on the distal\n                    radioulnar joint in an ulnar shortening procedure: a biomechanical study","volume":"93","author":"S Arimitsu","year":"2011","journal-title":"J Bone Joint Surg Am"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1016\/j.jhsa.2011.07.016","article-title":"The biomechanical effect of the distal interosseous membrane on distal\n                    radioulnar joint stability: a preliminary anatomic study","volume":"36","author":"T Kitamura","year":"2011","journal-title":"J Hand Surg Am"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1016\/j.jhsa.2005.06.013","article-title":"Contribution of the interosseous membrane to distal radioulnar joint\n                    constraint","volume":"30","author":"H Watanabe","year":"2005","journal-title":"J Hand Surg Am"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1055\/s-2000-10915","article-title":"Vergleichende Ergebnisbewertung am Handgelenk - 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