Ulnar Shortening Osteotomy for the Treatment of Ulnar Impaction Syndrome

PURPOSE: To compare the clinical outcomes of the ulnar shortening osteotomy alone and the ulnar shortening osteotomy with arthroscopic debridement in the idiopathic ulnar impaction syndrome with positive ulnar variance. MATERIALS AND METHODS: Twenty seven cases, who underwent the ulnar shortening osteotomy with or without arthroscopic debridement for treatment of the idiopathic ulnar impaction syndrome with positive ulnar variance, were included. The mean age was 40.3 years (range, 21 to 63 years) and the mean follow-up period was 20.6 months (range, 12 to 60 months). The ulnar shortening osteotomy alone and the ulnar shortening osteotomy with arthroscopic debridement were performed in 14 and 13 cases respectively. Pre- and postoperative functional results of the wrist were evaluated by the modified Mayo wrist score. RESULTS: The ulnar variance was corrected from 4.61 mm (range, 1.8~10 mm) to -0.06 mm (range, -3.3~3.1 mm) in the ulnar shortening osteotomy alone group and from 3.01 mm (range, 1.2~7.6 mm) to -0.74 mm (range, -1.8~0 mm) in the ulnar shortening osteotomy with arthroscopic debridement group. The final results of the ulnar shortening osteotomy alone were excellent in 4 cases, good in 5 cases, and fair in 5 cases. Those of the ulnar shortening osteotomy with arthroscopic debridement group were excellent in 6 cases, good in 2 cases, fair in 1 case, and poor in 2 cases. The modified Mayo wrist score at the last follow-up were 83.57(range, 75~100) in the ulnar shortening osteotomy alone group and 83.35(range, 40~100) in the ulnar shortening osteotomy with arthroscopic debirdement group. No statistically significant difference was demonstrated between two groups (p=0.43). CONCLUSION: The ulnar shortening osteotomy is valuable treatment for the idiopathic ulnar impaction syndrome with positive ulnar variance. The combined arthroscopic debridment does not appear to have positive influence to the final results.

Two Cases of Squamous Cell Carcinoma of the Bulbar Conjunctiva

Squamous cell carcinoma of the bulbar conjunctiva is a rare disease and usually arise at the limbus and spread to the cornea and adjacent bulbar conjunctiva. The authers experienced two cases of squamous cell carcinoma of the bulbar conjunctiva. In the first case, a 30-year old male visited our hospital in February, 1969 with a congested granulomatous hypertrophy in the nasal side of the bulbar conjunctiva(OD) which had showed progressive enlargement of 3 months duration. An excisional biopsy was carried out and histopathological examination revealed bulbar squamous cell carcinoma. In second case, a 51-year old female visited our hospital in January, 1977 with recurrent mild conjunctival injection and a small whitish elevated mass in the temporal side of the bulbar conjunctiva(OD) which had showed progressive enlargement of 7 months duration. The elevated mass was resected and histopathological examination revealed bulbar squamous cell carcinoma. We had a study of the histopathological finding for two cases of squamous cell carcinoma of the bulbar conjunctiva with a brief review of relating literatures.

5 Cases of Interstitial Keratitis Due to Congenital Syphilis

Syphilitic interstitial keratitis is known as a rare disease in recent time. Authors experienced 5 cases of interstitial keratitis due to congenital syphilis. All the cases sh owed positive serologic test for syphilis (VDRL), 4 cases showed Hutchinson's teeth and 2 cases showed iritis. A brief review and relating literatures are presented.