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Old 08-29-2010, 08:22 PM   #1
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thederro HB User
ulnar shortening osteotomy

hi all

this is a long post so i hope it's still active...

me: 33, male, 6 foot 3. genetically positive ulnar variance in both wrists, which has never been an issue.

18 months ago i had a cycling accident in which i damaged the TFCC in my right wrist. xrays have always been clear but MRI showed up damage, surgeon can't tell how much without an arthroscope.

initially i had a lot of pain but that has subsided and now the only symptom is weakness in the wrist - i would say it's about 70-80% of the strength it used to be. as it's my dominant wrist this is frustrating but given there is no pain i've been able to live with it.

surgery is planned for thursday where they intend to repair/debride the TFCC through an arthroscope but they also want to do the ulnar shortening osteotomy. reason being that the positive ulnar variance means i'll never fully regain the strength even with the 'repaired' TFCC.

having read through a lot of the posts here i only saw one mention of loss of strength after the surgery. i'm keen to hear from anyone else that may have had either positive or negative outcomes in terms of the strength of the wrist after surgery?

thanks
chris

Last edited by moderator2; 08-30-2010 at 05:41 AM. Reason: to start your own new thread instead of posting on an old one

 
Old 08-30-2010, 04:25 AM   #2
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budgiemcdo HB User
Re: ulnar shortening osteotomy complication

Hi,

I had the ulnar shortening op last year and had a very good and easy recovery, it took a bit of time and lots of hard work but I regained almost full strength and movement within a couple of months of surgery. I noticed the other day that I don't have equal strength in both hands but think that is down to me being right handed (ops on left arm) and previous surgeries.

Good luck with your op.

 
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Old 08-30-2010, 05:36 AM   #3
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ladyff1481 HB User
Re: ulnar shortening osteotomy complication

Hi all,
Thederro I am glad you found this site, it has been very informative for me and most everyone has had a good outcome. It also gives you an opportunity to make decisions about your medical care and ask questions of your surgeon.
I had the TFCC repair & ulnar shortening with placement of plate & screws in Feb 2010. I had fallen and initially fractured my radius/ulna in Mar. 2009.
After the TFCC repair/plate/screws & wearing a cast for 8 weeks I began Occupational Therapy 3x wk for 2 1/2 mos before stopping due to constant pain and only moderate ability to turn palm up and down.
I have since had a consultation with a hand surgeon who is going to perform a right wrist osteotomy/arthrotomy and removal of hardware as soon as workers comp approves it.
I just wanted you to think about your surgery. If you can live with the decreased strength it might be better for you. My surgeon is now telling me that with this new surgery he will be able to relieve my pain but I will also lose movement in my wrist. Right now my I can't do my job as a Nurse or my hobbies as a Firefighter and riding my Harley.

 
Old 08-31-2010, 08:29 PM   #4
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lsker HB User
Re: ulnar shortening osteotomy

Hi Chris,

I am 41 years old and have significant (6mm) postive variance in both of my wrists. They started bothering me about a year ago. The pain comes and goes depending on how much and what I do, but they actually are bothering me less now than they were a year ago. The MRI (w/o contrast) on my left wrist was unremarkable (but it is the one that bothers me the most). The MRI (w/o contrast) on the right wrist showed a probable TFCC attachment tear.

My #1 surgeon (I've seen 3) is one of the best, if not the best, hand surgeon in Pittsburgh. He told me a little less than a year ago to go and live my life within reason and that he would not even consider performing surgery until my pain level was unbearable and/or my condition worsened to the point that I couldn't do the things I love and came in begging for the surgery! He said surgery should always be the absolute last resort!! So that's what I've decided to do for now...

He told millions of people have positive ulnar variance...and some people never require surgery...however, some do...and there is no magic equation to figure out which ones will and won't...

I've been told the MRI's with contrast show much more...who knows my TFCC's could be a complete mess, but I can still function and do everything with no to very little pain...so there is no way I'm going mess with my wrists at all until I absolutely need to...and I'm hoping and praying for a miracle...so far so good!!

Good luck with your decision...It's a hard one I wrestled with for quite some time. Please let us know what you decide and how you are doing...

Lynne

 
Old 09-02-2010, 08:39 PM   #5
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thederro HB User
Re: ulnar shortening osteotomy

thanks all for the feedback, info and advice.

i met the surgeon one week before the op and debated the need for the osteotomy. he claimed i should have it done because of the positive variance, but i wasnt keen given i have no pain, full movement can live with the loss of strength. he was going to do the arthroscope anyway...

turned up for surgery yesterday and this time he agreed with me! he said some of his colleagues recommended definitely doing the osteotomy but others agreed with my point of view. lynne - i agree with you, some people will have positive variance and it will never be a problem... anyway, i can always do it later...

so, had the arthroscope yesterday that showed the tfcc was 'softened' but not torn... he debrided it but when he told me this i was still drugged up so will need to wait for the followup in 2 weeks for more detail. the arthroscope is failry minor... i was discharged that night and dont really have much pain now, just managing with voltaren in the day and panadiene forte at night (sorry australian drug names maybe?).

again, thanks for your advice. defintely happy to avoid the longer recovery, increased pain and major inconvenience of the osteotomy if i can...

ps. has anyone used the wrist widget that i've seen mentioned here? looks like it could be a good option for me...

cheers
chris

 
Old 09-02-2010, 10:45 PM   #6
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lsker HB User
Re: ulnar shortening osteotomy

Hi again!!

Glad to hear your surgery went well...so happy to hear that you didn't have the osteotomy and that your doctor agreed with you on that decision...can't wait to hear more details when you get them...

Hmmm...wondering what a "softened" TFCC is?...I wonder if that is what I could have? I still have almost, if not all my strength...but have mild occl. ulnar sided wrist pain...sometimes I wonder if it's just tendonitis caused by the long ulna bones rubbing on something...

I have two wrist widgets...they may be helpful for you...I felt like they were good support for my wrists...but for me I didn't notice any significant increase in my grip strength with them on...but like I said before...I don't believe my TFCC's are badly torn and my strength hasn't changed much with the wrist pain...Wendy the inventor of the wrist widget is very helpful and knows alot about our condition...you may want to give her a call or email her...she helped me alot in making my decision not to have surgery at this time.

 
Old 09-06-2010, 09:42 AM   #7
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Re: ulnar shortening osteotomy

Hi all,

I haven't written for a while but have seen a few posts and figured it was time. I am now almost 7 months post-op from the right wrist osteotomy and TFCC repair and over a year post-op on the left side. I've been able to work for the last 3.5 months but am still struggling with bilateral ulnar-sided pain and definitely with weakness. I'm more independent than I was 6 months ago but still can't lift anything over a few pounds, can't open an unopened bottle or one with a tight cap. I still have to wear braces every day and night - only taking them off to shower. I do have 2 wrist widgets and use them sometimes but have to alternate them with more restrictive braces.

My doc has now given up on me. At my last appt a few weeks ago, he told me that there isn't anything he can do for me medically but that doesn't mean I won't get better with time. He is closing out my case and I'm not being given any more pt or even equipment to do exercises at home.

It's been a very long and frustrating road. I do think they are getting slightly better but very, very slowly. Maybe someday I can not need braces and function more like a normal person.

I wish all of you the best and must faster and more complete recovery than I've had.

Best wishes,
ECK

 
Old 09-06-2010, 03:42 PM   #8
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lsker HB User
Re: ulnar shortening osteotomy

Hi Eck!!

Sorry to hear your recovery is going slower than you would like and expected...is your pain, range of motion, and/or strength any better than it was prior to your surgeries?

Hugs and lots of prayers going out to you for a complete and quicker recovery!

Lynne

 
Old 09-19-2010, 10:53 AM   #9
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Re: ulnar shortening osteotomy

Thanks! How are your wrists doing? I didn't have range of motion issues before surgery and don't have them now so I guess that's been the same. My wrists were weak and painful before surgery and still are now. I guess the biggest difference after the surgery is that I know my wrists aren't getting any worse and that I can't really do anything to damage them. But I don't believe there's a major difference with having had the surgery. Unfortunately, I think it took too long to diagnose and they kept getting worse; therefore, the damage to the cartilage of both wrists was already done. From what I've seen on this site, most others have had much greater success after surgery so I don't think I'm a great example of the "typical" recover.

Best wishes!
ECK

 
Old 09-19-2010, 11:12 AM   #10
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lsker HB User
Re: ulnar shortening osteotomy

Hi Eck!!

My wrists actually feel better than they did a year ago...I'm off the daily anti-inflammatories and I haven't been wearing my braces at all. I do take a daily bromelein supplement which is a natural anti-inflammatory and I'm also taking glucosamine + MSM. I'm back to doing everything I used to do pretty much pain-free, but I'm being very careful not to use my wrists to lift heavy things (my kids, etc) and/or put too much weight on my arms wrists (scrubbing the floors, push ups, etc). I'm not really sure what's going on with my wrists...the doctors told me they would only get worse over time and not better!! But, the doctor I liked best told me to go and live my life...and to come back if and when my wrists start to significantly interfere with my daily life. So that's what I'm trying to do...I don't feel like I'm doing major damage to them, but I'm not sure. I'm just trying to take one day at a time and not worry about the future. I hope I don't regret this decision in the future, but surgery right now doesn't even make sense.

Thanks for asking!!

Hope your wrists continue to improve!!

Lynne

 
Old 10-25-2010, 04:57 PM   #11
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ladyff1481 HB User
Re: ulnar shortening osteotomy

I'm am glad everyone seems to be doing well. I am scheduled for a right wrist arthrotomy with hardware removal on 11/9. Surgery to be done by hand specialist not my previous general orthopedic surgeon. I have faith that this procedure will be successful.

 
Old 03-25-2011, 02:53 PM   #12
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sjara HB User
Re: ulnar shortening osteotomy

Hi, I have questions for those of you that have had the surgery. I reinjured my wrist causing it to tear the remaining cartilage. I've been through splints,therapy, and cortizone again and can barely lift 10lbs at the most. I have been trying to avoid surgery but the pain seems to just keep coming back. The doctor now recommends to do the unlar shortening due to scar tissue i have now build and calcification on the head of the ulna. I'm just scared to do the surger because it sounds painful and i dont want to go through it and have no good results. My second option is to have permanent work restrictions and jst live with the pain. Have you guys have good results?

 
Old 03-26-2011, 02:36 PM   #13
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eck HB User
Re: ulnar shortening osteotomy

Hi there,

I'm not sure what I have to say will help. I've had ulna shortening osteotomies on both wrists along with debridement and still wear splints almost 24 hours a day and can't lift more than a few pounds. I've had 2 hand surgeons tell me that there's nothing else they can do for me.

On the bright side, almost everyone else on this site has had MUCH better results than I have. Hopefully some of them will weigh in so you can get both perspectives.

Good luck!
ECK

 
Old 03-26-2011, 02:54 PM   #14
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ladyff1481 HB User
Re: ulnar shortening osteotomy

Before you agree to the surgery I would suggest that you consult a surgeon that specializes in hands/wrists. My ulnar shortening was done 2/10 by a general surgeon and completely revised by a hand/wrist surgeon in 11/10. He removed the plate and screws and did a hemiarthrotomy after the ulnar shortening had brought the bones together causing impingement.

 
Old 04-04-2011, 05:42 PM   #15
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a1000cars HB User
Re: ulnar shortening osteotomy

I know its been a while since anyone has posted on this topic. However, I would like to give me 2 cents on the topic.
A little background:
1. Wrist pain started in March 2007
2. Went from doc to doc until may 2008
3. First surgery (May 2008) - Wrist Arthroscopy (sp?)
4. Re-tear in winter of 2009
5. Ulnar Osteotomy (June 2009)
6. After 2-3 months of physical therapy and some rehab on my own, I regained full range of motion and about 75% strength in my wrist.

Just this past month I finally started getting into a nice workout routine (mostly cardio) at my local YMCA. Once again, I am having pain in my left wrist that is just as bad as before I had my last surgery. For the last 2-3 weeks I have been on an ongoing regimen of ibuprophen and ice.

What brings me to this forum is that my google search triggered on 'glucosamine' in this thread. Has anyone had any luck with using a glucosamine and chondroitin product? I just purchased a product called 'Move Along' (with MSM and a large dose of Vitamin D). I have heard these products don't always work, but I am willing to try anything to prevent anymore pain in my wrist.

Any help or advice would be greatly appreciated.
Finally, anyone reading this and wanting to know if an ulnar osteotomy is worth the cost and risk, I have a few things to say...
At first I was very hesitant to have the surgery done. However, after considering my options I knew something had to be done (I am a computer programmer, therefore my hands are my job). If you DO decide on having the surgery done, be sure to find the best doctor in your area. I ended up having my surgery done by a very good surgeon at the University of Chicago - Med Center. Keep in mind, the surgery is the first step. There is quite a bit of pain after the surgery. However, there IS light at the end of the tunnel.

Kyle

 
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