Arthroscopic wafer procedure versus ulnar shortening osteotomy for ulnar impaction syndrome: a systematic review and meta-analysis

J Orthop Surg Res. 2024 Feb 20;19(1):149. doi: 10.1186/s13018-024-04611-4.

Abstract

Purpose: This study aimed to systematically compare the efficacy and safety of arthroscopic wafer procedure (AWP) versus ulnar shortening osteotomy (USO) for ulnar impaction syndrome (UIS) treatment.

Methods: All the studies included in this meta-analysis compared the efficacy of AWP to USO for UIS and were acquired through a comprehensive search across multiple databases. The meta-analysis was performed by calculating the effect sizes with the Cochrane Collaboration's RevMan 5.4 software.

Results: A total of 8 articles were included in this analysis, comprising 148 cases in the AWP group and 163 cases in the USO group. The pooled estimates indicated no significant differences in combined Darrow's Criteria or Modified Mayo Wrist Score, Modified Mayo Wrist Score, DASH scores, grip strength, VAS score, and postoperative ulnar variation. On the other hand, the patients in the AWP group exhibited fewer complications (OR = 0.17, 95%CI 0.05-0.54, P = 0.003) and a lower reoperation rate (OR = 0.12, 95%CI 0.05-0.28, P < 0.00001) than those in the USO group.

Conclusions: The two surgical techniques were both effective in treating UIS but the AWP group showed fewer complications and a lower reoperation rate. Therefore, AWP may present a superior alternative for UIS treatment.

Keywords: Arthroscopic wafer procedure; Meta-analysis; Ulnar impaction syndrome; Ulnar shortening osteotomy.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Arthroscopy* / methods
  • Humans
  • Joint Diseases* / surgery
  • Osteotomy / methods
  • Retrospective Studies
  • Treatment Outcome
  • Ulna / surgery
  • Wrist
  • Wrist Joint / surgery