Although conservative treatment of idiopathic ulnar impaction syndrome yielded improvements in objective and patient-reported outcomes, results published in Scientific Reports showed several nonmodifiable patient factors lead to a higher likelihood of treatment failure.
Young Hak Roh
At 24-weeks follow-up, Young Hak Roh, MD, PhD, and colleagues assessed response to treatment, including pain numeric rating scale on an ulnar provocation test, grip strength and DASH score, among 114 patients who underwent conservative treatment for idiopathic ulnar impaction syndrome.
Results showed significant clinical improvement in mean pain numeric rating scale score and DASH score at 24-weeks follow-up. Due to persistent symptoms after conservative treatment, researchers noted 25% of patients underwent ulnar shortening osteotomy. According to results, 16% of patients had pain scores greater than 5 at 24-weeks follow-up; however, these patients did not undergo surgery.
Multivariable logistic regression model showed an association of higher likelihood of treatment failure with female sex, duration of symptom, high pain numeric rating scale score on provocation test and enhanced carpal or distal ulna bone on MRI.
“Ulnar impaction syndrome is a common source of ulnar-sided wrist pain, yet not all cases of radiographic ulnar impaction are symptomatic. In this study, approximately two-thirds of patients showed improvements in both objective and patient-reported outcomes after conservative treatment for this condition,” Roh told Healio.com/Orthopedics. “However, female gender, long symptom duration, initial high pain [numeric rating scale] NRS score on ulnar provocation test and enhancement of carpal or distal ulna bone on MRI were associated with a higher likelihood of treatment failure. Knowledge of the factors offer physicians insight into predicting prognoses and can help patients set realistic expectations.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.