Minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union time

Objective: We aimed to define minimal clinically important difference (MCID) values of patient-reported outcome measures (PROMs) for distal metaphyseal ulnar shortening and to assess the relationship between level of the osteotomy and time to bone union. Methods: 20 patients who had distal metaph...

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Main Authors: Mustafa Özcan, Emre Acar, Onur Başçı, Mustafa Hulusi Özkan
Format: Article
Language:English
Published: AVES 2024-01-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:https://www.aott.org.tr/en/minimial-clinically-important-difference-values-in-distal-metaphyseal-ulnar-shortening-for-ulnar-impaction-syndrome-and-assessment-of-the-relationship-between-level-of-the-osteotomy-and-bone-u-time-137381
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author Mustafa Özcan
Emre Acar
Onur Başçı
Mustafa Hulusi Özkan
author_facet Mustafa Özcan
Emre Acar
Onur Başçı
Mustafa Hulusi Özkan
author_sort Mustafa Özcan
collection DOAJ
description Objective: We aimed to define minimal clinically important difference (MCID) values of patient-reported outcome measures (PROMs) for distal metaphyseal ulnar shortening and to assess the relationship between level of the osteotomy and time to bone union. Methods: 20 patients who had distal metaphyseal ulnar shortening osteotomies due to ulnar impaction syndrome and had at least 6 months of follow-ups were included in this study. The mean follow-up period was 12.3 ± 7.01 months. The PROMs which consisted of patient-rated wrist evaluation (PRWE) and quick disabilities of arm, shoulder, and hand (QDASH) were recorded on the day before the surgery and at follow-up assessments. Grip strength and range of motion were recorded for operated and contralateral wrists at postoperative assessments. Postoperative radiological evaluations of distance of the osteotomy from the distal ulnar articular surface (osteotomy level), the union of osteotomy site; preoperative and postoperative evaluations of styloid–triquetral distance, and ulnar variance were performed using AP wrist x-rays. The MCID values for PRWE and QDASH were calculated using ROC curve analysis. Results: Mean PRWE and QDASH scores decreased statistically significantly. The mean grip strength of contralateral wrists was higher. Mean ulnar variance decreased, whereas styloid–triquetral distance increased postoperatively. Patients with osteotomy levels of greater than 13.7 mm had a longer time from surgery to bone union. Furthermore, patients with time from surgery to bone union shorter than 7 weeks had an osteotomy closer to the ulnar articular surface. The MCID values for PRWE and QDASH were analyzed and calculated through the ROC curve as 22.25 and 20.45, respectively. Conclusion: This study has shown us that the osteotomy level affects the time to bone union and an osteotomy closer than 13.7 mm to the ulnar articular surface seems to result in shorter union time. Furthermore, MCID values were defined for PRWE and QDASH as 22.25 and 20.45, respectively. Level of Evidence: Level IV, Therapeutic Study.
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spelling doaj-art-b5a4d7f8fcce419996dd01fe9604e1782025-08-20T03:38:42ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2024-01-01581273310.5152/j.aott.2024.23111Minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union timeMustafa Özcan0Emre Acar1Onur Başçı2Mustafa Hulusi Özkan3Department of Orthopaedics and Traumatology, Ceylanpınar State Hospital, Şanlıurfa, TurkeyDepartment of Orthopaedics and Traumatology, Dokuz Eylül University Hospital, İzmir, TurkeyDepartment of Orthopaedics and Traumatology, Dokuz Eylül University Hospital, İzmir, TurkeyDepartment of Orthopaedics and Traumatology, Dokuz Eylül University Hospital, İzmir, TurkeyObjective: We aimed to define minimal clinically important difference (MCID) values of patient-reported outcome measures (PROMs) for distal metaphyseal ulnar shortening and to assess the relationship between level of the osteotomy and time to bone union. Methods: 20 patients who had distal metaphyseal ulnar shortening osteotomies due to ulnar impaction syndrome and had at least 6 months of follow-ups were included in this study. The mean follow-up period was 12.3 ± 7.01 months. The PROMs which consisted of patient-rated wrist evaluation (PRWE) and quick disabilities of arm, shoulder, and hand (QDASH) were recorded on the day before the surgery and at follow-up assessments. Grip strength and range of motion were recorded for operated and contralateral wrists at postoperative assessments. Postoperative radiological evaluations of distance of the osteotomy from the distal ulnar articular surface (osteotomy level), the union of osteotomy site; preoperative and postoperative evaluations of styloid–triquetral distance, and ulnar variance were performed using AP wrist x-rays. The MCID values for PRWE and QDASH were calculated using ROC curve analysis. Results: Mean PRWE and QDASH scores decreased statistically significantly. The mean grip strength of contralateral wrists was higher. Mean ulnar variance decreased, whereas styloid–triquetral distance increased postoperatively. Patients with osteotomy levels of greater than 13.7 mm had a longer time from surgery to bone union. Furthermore, patients with time from surgery to bone union shorter than 7 weeks had an osteotomy closer to the ulnar articular surface. The MCID values for PRWE and QDASH were analyzed and calculated through the ROC curve as 22.25 and 20.45, respectively. Conclusion: This study has shown us that the osteotomy level affects the time to bone union and an osteotomy closer than 13.7 mm to the ulnar articular surface seems to result in shorter union time. Furthermore, MCID values were defined for PRWE and QDASH as 22.25 and 20.45, respectively. Level of Evidence: Level IV, Therapeutic Study.https://www.aott.org.tr/en/minimial-clinically-important-difference-values-in-distal-metaphyseal-ulnar-shortening-for-ulnar-impaction-syndrome-and-assessment-of-the-relationship-between-level-of-the-osteotomy-and-bone-u-time-137381
spellingShingle Mustafa Özcan
Emre Acar
Onur Başçı
Mustafa Hulusi Özkan
Minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union time
Acta Orthopaedica et Traumatologica Turcica
title Minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union time
title_full Minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union time
title_fullStr Minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union time
title_full_unstemmed Minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union time
title_short Minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union time
title_sort minimial clinically important difference values in distal metaphyseal ulnar shortening for ulnar impaction syndrome and assessment of the relationship between level of the osteotomy and bone union time
url https://www.aott.org.tr/en/minimial-clinically-important-difference-values-in-distal-metaphyseal-ulnar-shortening-for-ulnar-impaction-syndrome-and-assessment-of-the-relationship-between-level-of-the-osteotomy-and-bone-u-time-137381
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