Objective To explore the impact of the postoperative anatomical changes in distal radioulnar joint (DRUJ) congruence in patients with ulnar impaction syndrome on clinical efficacy and functional recovery, and to provide clinical evidence for optimizing surgical strategies. Methods A retrospective analysis was conducted on the perioperative data of 10 patients who underwent ulnar shortening osteotomy in the hand surgery department of our hospital between July 2023 and March 2025. Based on the preoperative and postoperative imaging evaluations of the distal radioulnar joint Tolat classification changes, the operative time, postoperative pain duration, return-to-work time, and functional outcomes (pain score, wrist joint range of motion, grip strength, QuickDASH score, and modified Mayo Wrist Score) were recorded. Results The follow-up period was 3 to18 months. After operation, the distribution of DRUJ classification shifted, with transitions from Tolat type 3 to Tolat types 1 and Tolat type 2. The postoperative pain scores, Quick DASH scores, range of flexion and extension, grip strength, and modified Mayo Wrist Scores all improved compared to the preoperative values (P<0.05). Those with greater variability in the distal radioulnar joint had a longer duration of postoperative pain compared to those with less variability(P<0.05). Conclusions Postoperative pain after ulnar shortening osteotomy is closely associated with alterations in the congruence state of the distal radioulnar joint. Maintaining the anatomical congruence of the DRUJ may facilitate faster functional recovery. Under the concept of enhanced recovery after surgery, preservation of DRUJ congruence can positively influence clinical outcomes.
Key words
Ulnar impaction syndrome /
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Distal radioulnar joint /
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Ulnar shortening osteotomy /
Enhanced recovery after surgery (ERAS)
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