{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:02:10Z","timestamp":1789603330243,"version":"build-2803163510"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Das Ulna-Impaction-Syndrom (UIS) ist eine h\u00e4ufige Diagnose bei ulnarseitigen\n                    Handgelenkschmerzen. Es wird traditionell als mechanisches \u00dcberlastungssyndrom\n                    infolge einer positiven Ulnavarianz verstanden. Etablierte Therapieans\u00e4tze\n                    zielen meist auf eine kn\u00f6cherne Entlastung ab, vorrangig durch die\n                    Ulnaverk\u00fcrzungsosteotomie (UVO) oder die arthroskopische Wafer-Operation\n                    (AWO).<\/jats:p>\n                  <jats:p>Dieser \u00dcbersichtsartikel liefert eine kritische Bestandsaufnahme zum\n                    biomechanischen Modell und den Behandlungsstrategien des idiopathischen UIS\n                    anhand aktueller Literatur und epidemiologischer Daten.<\/jats:p>\n                  <jats:p>Die Literatur belegt, dass sowohl kongenitale Ulna-Plus-Varianten als auch\n                    degenerative L\u00e4sionen des triangul\u00e4ren fibrokartilagin\u00e4ren Komplexes (TFCC) in\n                    der asymptomatischen Normalbev\u00f6lkerung sehr h\u00e4ufig sind und daher per se keinen\n                    pathologischen Befund darstellen. Zudem ist die radiologische Bestimmung der\n                    Ulnavarianz methodisch inkonsistent. Die Pr\u00e4misse, dass die kn\u00f6cherne \u00dcberl\u00e4nge\n                    als alleiniger Schmerzgenerator operativ korrigiert werden muss, wird zudem\n                    durch die hohen klinischen Erfolgsraten konservativer Therapien sowie isolierter\n                    arthroskopischer TFCC-D\u00e9bridements infrage gestellt. Zwar k\u00f6nnen durch UVO und\n                    AWO gute klinische Resultate erzielt werden, jedoch ist insbesondere die UVO mit\n                    erheblicher Komplikations- und hohen Reoperationsraten von bis zu \u00fcber 60%\n                    assoziiert, prim\u00e4r bedingt durch Materialirritationen und Pseudarthrosen.<\/jats:p>\n                  <jats:p>Das kongenitale UIS wird aufgrund unspezifischer Kriterien potenziell\n                    \u00fcberdiagnostiziert und \u00fcbertherapiert. Eine strenge differenzialdiagnostische\n                    Abkl\u00e4rung ist zwingend erforderlich und ein stufenweises Vorgehen zu empfehlen.\n                    Die prim\u00e4re Therapie sollte konservativ oder mittels arthroskopischer\n                    Weichteileingriffe (D\u00e9bridement) erfolgen. Kn\u00f6cherne Verk\u00fcrzungsverfahren\n                    sollten aufgrund ihres ausgepr\u00e4gten Komplikationsprofils streng indiziert und\n                    ausschlie\u00dflich therapieresistenten F\u00e4llen vorbehalten bleiben.<\/jats:p>","DOI":"10.1055\/a-2938-7301","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:09:38Z","timestamp":1789600178000},"source":"Crossref","is-referenced-by-count":0,"title":["Das Ulna-Impaction-Syndrom \u2013 eine kritische Literaturanalyse"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7951-6672","authenticated-orcid":false,"given":"Kai","family":"Megerle","sequence":"additional","affiliation":[{"name":"Sch\u00f6n Klinik M\u00fcnchen Harlaching, Bayern, Germany","place":["M\u00fcnchen"],"department":["Zentrum f\u00fcr Handchirurgie, Mikrochirurgie und plastische\n                    Chirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.2106\/00004623-200407000-00030","article-title":"Ulnar-sided wrist pain: diagnosis and treatment","volume":"86","author":"A Y Shin","year":"2004","journal-title":"JBJS"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/0363-5023(89)90175-5","article-title":"Measuring ulnar variance: a comparison of techniques","volume":"14","author":"C M Steyers","year":"1989","journal-title":"The Journal of hand surgery"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/0363-5023(89)90174-3","article-title":"Triangular fibrocartilage complex lesions: a classification","volume":"14","author":"A K Palmer","year":"1989","journal-title":"The Journal of hand surgery"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/00003086-198407000-00005","article-title":"Biomechanics of the distal radioulnar joint","volume":"187","author":"A K Palmer","year":"1984","journal-title":"Clinical Orthopaedics & Related Research"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1055\/s-0044-1788706","article-title":"Distal Radioulnar Joint Orientation and Lunate Morphology as Protective Factors\n                    of Symptomatic Idiopathic Ulnar Impaction Syndrome in Ulnar-Positive Variant\n                    Patients","volume":"14","author":"S K Shin","year":"2025","journal-title":"Journal of Wrist Surgery"},{"key":"ref6","first-page":"367","article-title":"Age changes in the triangular fibrocartilage of the wrist joint","volume":"126","author":"Z Miki\u0107","year":"1978","journal-title":"Journal of Anatomy"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/0363-5023(92)90342-M","article-title":"Force transmission through the distal ulna: effect of ulnar variance, lunate\n                    fossa angulation, and radial and palmar tilt of the distal radius","volume":"17","author":"F W Werner","year":"1992","journal-title":"The Journal of hand surgery"},{"key":"ref9","first-page":"27","article-title":"Distal radius morphometry in the Malaysian population. 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