{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T20:04:31Z","timestamp":1774382671504,"version":"3.50.1"},"reference-count":49,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>Background: This study aimed to evaluate the clinical outcomes and changes in distal radioulnar joint (DRUJ) stability in patients with ulnar impaction syndrome (UIS) combined with DRUJ instability, treated with ulnar shortening osteotomy (USO) without concomitant triangular fibrocartilage complex (TFCC) repair.Materials and methods: Between November 2017 and December 2024, a total of 16 patients (7 males, 9 females; mean age, 40 \u00b1 12 years) underwent USO combined with wrist arthroscopy, followed by structured rehabilitation and regular follow-up. Clinical outcomes were assessed using ulnar variance, the Ballottement test, visual analog scale (VAS) for pain, Disabilities of the Arm, Shoulder, and Hand (DASH) score, modified Mayo wrist score, Patient-Rated Wrist Evaluation (PRWE), grip strength, and wrist range of motion. Preoperatively, all patients had positive Ballottement tests, and TFCC injuries were confirmed by arthroscopy.\nResults: At the final follow-up (mean, 31 months), ulnar variance was significantly reduced, and VAS, DASH, modified Mayo wrist score, PRWE, and grip strength all showed marked improvement. DRUJ stability was restored in all patients, with the Ballottement test converting to negative.\nConclusions: These findings suggest that isolated USO effectively treats UIS with concurrent DRUJ instability and achieves satisfactory clinical outcomes without the need for simultaneous TFCC repair.\nType of study\/level of evidence: Therapeutic, Level IV.<\/jats:p>","DOI":"10.2340\/jphs.v61.45517","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T16:30:34Z","timestamp":1774369834000},"page":"44-50","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes of isolated ulnar shortening osteotomy for ulnar impaction syndrome with concomitant distal radioulnar joint instability"],"prefix":"10.2340","volume":"61","author":[{"given":"Xing","family":"Gao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aozhengzheng","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingxin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changliang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wencui","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianquan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiqin","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"146174","doi-asserted-by":"crossref","unstructured":"Mwaturura T, Daneshvar P, Pike J, et al. Clinical and radiographic correlates for the treatment of ulnocarpal impaction. J Wrist Surg. 2019;8(3):192\u2013197.","DOI":"10.1055\/s-0038-1677534"},{"key":"146175","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1055\/s-0038-1677534","DOI":"10.1055\/s-0038-1677534"},{"key":"146176","doi-asserted-by":"crossref","unstructured":"Stockton DJ, Pelletier ME, Pike JM. Operative treatment of ulnar impaction syndrome: a systematic review. J Hand Surg Eur Vol. 2015;40(5):470\u2013476.","DOI":"10.1177\/1753193414541749"},{"key":"146177","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1177\/1753193414541749","DOI":"10.1177\/1753193414541749"},{"key":"146178","doi-asserted-by":"crossref","unstructured":"Hontani K, Matsui Y, Kawamura D, et al. Stress distribution pattern in the distal radioulnar joint before and after ulnar shortening osteotomy in patients with ulnar impaction syndrome. Sci Rep Uk. 2021;11(1):17891.","DOI":"10.1038\/s41598-021-97398-x"},{"key":"146179","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1038\/s41598-021-97398-x","DOI":"10.1038\/s41598-021-97398-x"},{"key":"146180","doi-asserted-by":"crossref","unstructured":"Nishiwaki M, Nakamura T, Nagura T, et al. Ulnar-shortening effect on distal radioulnar joint pressure: a biomechanical study. J Hand Surg Am. 2008;33(2):198\u2013205.","DOI":"10.1016\/j.jhsa.2007.11.024"},{"key":"146181","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jhsa.2007.11.024","DOI":"10.1016\/j.jhsa.2007.11.024"},{"key":"146182","doi-asserted-by":"crossref","unstructured":"Sachar K. Ulnar-sided wrist pain: evaluation and treatment of triangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears. J Hand Surg Am. 2012;37(7):1489\u20131500.","DOI":"10.1016\/j.jhsa.2012.04.036"},{"key":"146183","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jhsa.2012.04.036","DOI":"10.1016\/j.jhsa.2012.04.036"},{"key":"146184","doi-asserted-by":"crossref","unstructured":"Pirolo JM, Yao J. Minimally invasive approaches to ulnar-sided wrist disorders. Hand Clin. 2014;30(1):77\u201389.","DOI":"10.1016\/j.hcl.2013.09.001"},{"key":"146185","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.hcl.2013.09.001","DOI":"10.1016\/j.hcl.2013.09.001"},{"key":"146186","doi-asserted-by":"crossref","unstructured":"Im JH, Lee JY, Kang HV. The combined procedure of ulnar metaphyseal shortening osteotomy with triangular fibrocartilage complex foveal knotless repair. J Hand Surg Am. 2021;46(9):821\u2013822.","DOI":"10.1016\/j.jhsa.2021.01.021"},{"key":"146187","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jhsa.2021.01.021","DOI":"10.1016\/j.jhsa.2021.01.021"},{"key":"146188","doi-asserted-by":"crossref","unstructured":"Shi H, Huang Y, Shen Y, et al. Arthroscopic wafer procedure versus ulnar shortening osteotomy for ulnar impaction syndrome: a systematic review and meta-analysis. J Orthop Surg Res. 2024;19(1):149.","DOI":"10.1186\/s13018-024-04611-4"},{"key":"146189","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1186\/s13018-024-04611-4","DOI":"10.1186\/s13018-024-04611-4"},{"key":"146190","doi-asserted-by":"crossref","unstructured":"Shaer SA, van der Palen J, Teunissen J, et al. An alternative treatment for degenerative triangular fibrocartilage complex injuries with distal radioulnar joint instability: first experience with 48 patients. J Hand Surg Eur Vol. 2024;49(2):240\u2013249.","DOI":"10.1177\/17531934231197942"},{"key":"146191","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1177\/17531934231197942","DOI":"10.1177\/17531934231197942"},{"key":"146192","doi-asserted-by":"crossref","unstructured":"Lu C, Wang P, Zhang L, et al. Clinical study of wrist arthroscopy combined with oblique ulnar shortening osteotomy in the treatment of ulnar impaction syndrome. Orthop Surg. 2022;14(11):2947\u20132954.","DOI":"10.1111\/os.13428"},{"key":"146193","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1111\/os.13428","DOI":"10.1111\/os.13428"},{"key":"146194","doi-asserted-by":"crossref","unstructured":"Kim BS, Song HS. A comparison of ulnar shortening osteotomy alone versus combined arthroscopic triangular fibrocartilage complex debridement and ulnar shortening osteotomy for ulnar impaction syndrome. Clin Orthop Surg. 2011;3(3): 184\u2013190.","DOI":"10.4055\/cios.2011.3.3.184"},{"key":"146195","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.4055\/cios.2011.3.3.184","DOI":"10.4055\/cios.2011.3.3.184"},{"key":"146196","doi-asserted-by":"crossref","unstructured":"Seo JB, Kim JP, Yi HS, et al. The outcomes of arthroscopic repair versus debridement for chronic unstable triangular fibrocartilage complex tears in patients undergoing ulnar-shortening osteotomy. J Hand Surg Am. 2016;41(5):615\u2013623.","DOI":"10.1016\/j.jhsa.2016.02.009"},{"key":"146197","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jhsa.2016.02.009","DOI":"10.1016\/j.jhsa.2016.02.009"},{"key":"146198","doi-asserted-by":"crossref","unstructured":"de Runz A, Pauchard N, Sorin T, et al. Ulna-shortening osteotomy: outcome and repercussion of the distal radioulnar joint osteoarthritis. Plast Reconstr Surg. 2016;137(1):175\u2013184.","DOI":"10.1097\/PRS.0000000000001870"},{"key":"146199","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/PRS.0000000000001870","DOI":"10.1097\/PRS.0000000000001870"},{"key":"146200","doi-asserted-by":"crossref","unstructured":"Baek GH, Lee HJ, Gong HS, et al. Long-term outcomes of ulnar shortening osteotomy for idiopathic ulnar impaction syndrome: at least 5-years follow-up. Clin Orthop Surg. 2011;3(4):295\u2013301.","DOI":"10.4055\/cios.2011.3.4.295"},{"key":"146201","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.4055\/cios.2011.3.4.295","DOI":"10.4055\/cios.2011.3.4.295"},{"key":"146202","unstructured":"Hong J, Jiyang T, Xiaodong F, et al. Finite element analysis of altered contact stress in the distal radioulnar joint following shortening osteotomy of the ulnar diaphyseal metaphysis. Chinese J Hand Surg. 2023;39(5):431\u2013436."},{"key":"146203","doi-asserted-by":"crossref","unstructured":"Atzei A, Luchetti R, Carletti D, et al. The hook test is more accurate than the trampoline test to detect foveal tears of the triangular fibrocartilage complex of the wrist. Arthroscopy. 2021;37(6):1800\u20131807.","DOI":"10.1016\/j.arthro.2021.03.005"},{"key":"146204","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.arthro.2021.03.005","DOI":"10.1016\/j.arthro.2021.03.005"},{"key":"146205","doi-asserted-by":"crossref","unstructured":"Jens S, Luijkx T, Smithuis FF, et al. Diagnostic modalities for distal radioulnar joint. J Hand Surg Eur Vol. 2017;42(4):395\u2013404.","DOI":"10.1177\/1753193416683876"},{"key":"146206","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1177\/1753193416683876","DOI":"10.1177\/1753193416683876"},{"key":"146207","doi-asserted-by":"crossref","unstructured":"Cho JY, Lee SW, Kim DH, et al. Prognostic factors for clinical outcomes after arthroscopic treatment of traumatic central tears of the triangular fibrocartilage complex. Bone Joint J. 2024;106-B(4): 380\u2013386.","DOI":"10.1302\/0301-620X.106B4.BJJ-2023-0642.R3"},{"key":"146208","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1302\/0301-620X.106B4.BJJ-2023-0642.R3","DOI":"10.1302\/0301-620X.106B4.BJJ-2023-0642.R3"},{"key":"146209","doi-asserted-by":"crossref","unstructured":"Chan SK, Singh T, Pinder R, et al. Ulnar shortening osteotomy: are complications under reported? J Hand Microsurg. 2015;7(2):276\u2013282.","DOI":"10.1007\/s12593-015-0201-7"},{"key":"146210","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s12593-015-0201-7","DOI":"10.1007\/s12593-015-0201-7"},{"key":"146211","doi-asserted-by":"crossref","unstructured":"Miyashima Y, Uemura T, Okada M, et al. Comparison of dynamic compression plate systems with oblique osteotomy and locking plate fixation versus transverse osteotomy and non-locking plate fixation for ulnar shortening osteotomy. J Orthop Sci. 2025;30(5):798\u2013804.","DOI":"10.1016\/j.jos.2024.11.007"},{"key":"146212","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jos.2024.11.007","DOI":"10.1016\/j.jos.2024.11.007"},{"key":"146213","doi-asserted-by":"crossref","unstructured":"Koh KH, Lee HL, Chang YS, et al. Arthroscopy during ulnar shortening for idiopathic ulnar impaction syndrome. Orthopedics. 2013;36(12):e1495\u2013e1500.","DOI":"10.3928\/01477447-20131120-12"},{"key":"146214","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3928\/01477447-20131120-12","DOI":"10.3928\/01477447-20131120-12"},{"key":"146215","doi-asserted-by":"crossref","unstructured":"Arimitsu S, Moritomo H, Kitamura T, et al. The stabilizing effect of the distal interosseous membrane on the distal radioulnar joint in an ulnar shortening procedure: a biomechanical study. J Bone Joint Surg Am. 2011;93(21):2022\u20132030.","DOI":"10.2106\/JBJS.J.00411"},{"key":"146216","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.2106\/JBJS.J.00411","DOI":"10.2106\/JBJS.J.00411"},{"key":"146217","doi-asserted-by":"crossref","unstructured":"Kong L, Zhai Y, Zhang Z, et al. Radiocarpal joint stiffness following surgical treatment for distal radius fractures: the incidence and associated factors. J Orthop Surg Res. 2020;15(1):313.","DOI":"10.1186\/s13018-020-01857-6"},{"key":"146218","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1186\/s13018-020-01857-6","DOI":"10.1186\/s13018-020-01857-6"},{"key":"146219","doi-asserted-by":"crossref","unstructured":"Tatebe M, Horii E, Nakao E, et al. Repair of the triangular fibrocartilage complex after ulnar-shortening osteotomy: second-look arthroscopy. J Hand Surg Am. 2007;32(4):445\u2013449.","DOI":"10.1016\/j.jhsa.2007.01.013"},{"key":"146220","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jhsa.2007.01.013","DOI":"10.1016\/j.jhsa.2007.01.013"},{"key":"146221","doi-asserted-by":"crossref","unstructured":"Cha SM, Shin HD, Ahn BK. Refracture after plate removal following ulnar shortening osteotomy for ulnar impaction syndrome \u2013 a retrospective case-control study. J Plast Surg Hand Su. 2021;55(1):48\u201355.","DOI":"10.1080\/2000656X.2020.1828900"},{"key":"146222","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1080\/2000656X.2020.1828900","DOI":"10.1080\/2000656X.2020.1828900"}],"container-title":["Journal of Plastic Surgery and Hand Surgery"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/45517\/53275","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/45517\/53275","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T16:30:54Z","timestamp":1774369854000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/view\/45517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,24]]},"references-count":49,"URL":"https:\/\/doi.org\/10.2340\/jphs.v61.45517","relation":{},"ISSN":["2000-6764"],"issn-type":[{"value":"2000-6764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,24]]}}}