Treatment of Ulnar Impaction Syndrome A Systematic Review

M.G.El-D.Alashhab, O.M.Essawy, E.A.Tabl and A.S.Elshahat"


This thesis critically and systematically reviews the surgical treatments for ulnar impaction syndrome. Three types of treatments currently exist: arthroscopic wafer procedure, open wafer procedure, and ulna shortening osteotomy. We aim in this study to systematically review the literature to assess the treatment of the ulnar impaction syndrome which will help in establishing an algorithm for the treatment. By September 2018, we conducted a search on five electronic databases, including PubMed, Scopus, Institute of Science Index (ISI), Google Scholar and Cochrane. We used the following search terms to retrieve the articles that may relate to our topic: (ulnar abutment syndrome, ulnar impaction syndrome) A total of 36 articles were included from searching the electronic databases PubMed MEDLINE, Ovid MEDLINE, and Ovid EMBASE. Studies were evaluated for quality using the Modified Detsky Score. Of these, 14 articles had a Modified Detsky Score of 6/10 or higher. Satisfaction rates were 100% for arthroscopic wafer procedure, 89% for open wafer procedure, and 84% for ulna shortening osteotomy. The percentage of participants reporting an excellent or good outcome was 82% for arthroscopic wafer procedure, 87% for open wafer procedure, and 76% for ulna shortening osteotomy. Available evidence shows that arthroscopic wafer procedure and open wafer procedure may be viable alternatives to the more popular ulna shortening osteotomy, but clinical superiority is yet to be established. Future research should focus on prospective cohort methods and should report participant outcomes using validated scoring methods.

Key words

Wafer procedure, Outcome, Modified Detsky Score, Ulnar impaction syndrome.