Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2023; 11(12): 2753-2765
Published online Apr 26, 2023. doi: 10.12998/wjcc.v11.i12.2753
Is metaphyseal ulnar shortening osteotomy superior to diaphyseal ulnar shortening osteotomy in the treatment of ulnar impaction syndrome? A meta-analysis
Hai-Lin Deng, Ming-Ling Lu, Zhe-Ming Tang, Qing-Long Mao, Jin-Min Zhao
Hai-Lin Deng, Jin-Min Zhao, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Ming-Ling Lu, Ministry of Public Health, Department of Public Health Unit, Liuzhou Liunan District Center for Disease Control, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China
Zhe-Ming Tang, Qing-Long Mao, Department of Hand, Foot and Ankle Surgery, Liuzhou Workers' Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China
Author contributions: Deng HL and Zhao JM concepted the study; Deng HL, Lu ML and Mao QL collected the data; Deng HL, Lu ML, Tang ZM and Zhao JM contributed to the formal analysis; Deng HL and Zhao JM contributed to the investigation; Deng HL, Zhao JM and Lu ML contributed to the methodology; Deng HL, Zhao JM, Tang ZM and Lu ML supervised the study; Zhao JM validated the study; Deng HL and Lu ML contributed to the visualization of the study; Deng HL and Lu ML originally drafted the manuscript; Deng HL, Zhao JM, Tang ZM and Mao QL reviewed and edited the manuscript.
Conflict-of-interest statement: There is no conflict of interest.
PRISMA 2009 Checklist statement: The authors read the PRISMA 2009 checklist and prepared and revised the manuscript according to the PRISMA 2009 checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Min Zhao, MD, Professor, Guangxi Medical University, No. 22 Shuangyong Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China. denallen@163.com
Received: February 19, 2023
Peer-review started: February 19, 2023
First decision: February 28, 2023
Revised: March 6, 2023
Accepted: March 24, 2023
Article in press: March 24, 2023
Published online: April 26, 2023
ARTICLE HIGHLIGHTS
Research background

Although metaphyseal ulnar shortening osteotomy (MUSO) is safer for the treatment of ulnar impaction syndrome (UIS) than diaphyseal ulnar shortening osteotomy (DUSO), DUSO is widely used for UIS treatment.

Research motivation

It is unknown whether any factor should be considered when choosing DUSO or MUSO for UIS treatment or whether it should be based on surgeon’s decision only. This study tries to give some references to the surgeons.

Research objectives

This meta-analysis aimed to evaluate the effectiveness of DUSO and MUSO for UIS treatment and determine the factors that should be considered when choosing surgical treatment for UIS.

Research methods

Cochrane Library, MEDLINE (Ovid), PubMed, and EMBASE databases were searched. A manual search was also conducted on the relevant research to ensure that no research was omitted.

Research results

Two sample t-test showed that the postoperative grip strength of the unaffected extremity was not significantly different between the two groups. Two sample t-test was also applied to compare postoperative grip strength outcomes between two common lengths of ulnar shortening osteotomy. The postoperative grip strength outcomes were not significantly different between the 2.5-mm and 3.0-mm groups. However, the pre- and postoperative percentages of grip strength of the contralateral wrist were significantly different between the two groups. Specifically, grip strength improved by 32% and 28% in the MUSO group and DUSO group, respectively.

Research conclusions

Although DUSO and MUSO have similar effect for UIS treatment, MUSO is associated with a lower secondary procedure rate, slightly lower postoperative DASH score, and slightly better pain relief, and thus is suitable for UIS treatment.

Research perspectives

Although MUSO can be used for UIS treatment, it has not been verified in many patients. A large-scale and appropriate research requires long-term outcomes to distinguish and describe the benefits of one technology over another. Besides, previous retrospective studies had inherent selection biases using different surgical techniques and equipment. Most included studies did not consider or report the etiology of UIS. Therefore, large sample size, multicenter prospective studies are needed to verify the above results. Besides, these studies should use unified surgical techniques and equipment for clearer conclusions. Surgical interventions were not randomly allocated because of ethical reasons. This meta-analysis summarized the bias risk of the included studies, pooled the selected outcomes, and compared the different outcomes between MUSO and DUSO for UIS treatment.