Is metaphyseal ulnar shortening osteotomy superior to diaphyseal ulnar shortening osteotomy in the treatment of ulnar impaction syndrome?A meta-analysis

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.AIM 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.METHODS Articles comparing the effectiveness of DUSO and MUSO for UIS treatment were systematically retrieved from MEDLINE(Ovid),PubMed,EMBASE,and Cochrane Library.The demography,incidence of complications,secondary operation rate,postoperative DASH score,wrist pain on the visual analogue scale,and grip strength improvement were also evaluated.In addition,the correlation between the improvement of grip strength and the shortening of osteotomy length of ulna was analyzed.The outcome of the patient was discontinuous,and the odds ratio,risk ratio(RR),and 95%CI were calculated and analyzed via RevMan5.3 software.RESULTS Six studies,including 83 patients receiving MUSO(experimental group)and 112 patients receiving DUSO(control group),were included in the meta-analysis.The second operation rate was significantly higher after DUSO than after MUSO.The DASH scores were slightly lower in the MUSO group than in the DUSO group.The patients receiving MUSO had slightly better pain relief effect than patients receiving DUSO.However,the incidence of complications and improvement of grip strength were not significantly different between the two groups.CONCLUSION Although DUSO and MUSO provide similar effects for UIS,MUSO is associated with a lower secondary operation rate,slightly lower postoperative DASH scores and slightly better pain relief effect than DUSO,indicating that MUSO can effectively be used for UIS treatment.

The Impact of Cigarette Smoking on Metabolic Syndrome

Metabolic syndrome （MetS） is a constellation of interconnected cardiometabolic disorders, including obesity, hyperglycemia, dyslipidemia, and elevated blood pressure. MetS is a precursor to type 2 diabetes mellitus （T2DM） and cardiovascular disease （CVD）; it increases the risk of T2DM by 3-4 times[11 and the risk of CVD by 1.4-fold[21, and is more prevalent in obese individuals. As the obesity rates increase, the prevalence of MetS in the population is increased. In 2006, the global prevalence of MetS in adults was estimated to be 20%-25%TM, and in China, in 2007-2008, using the criteria of the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults （JCDCG）, it reached 21.9% among the adult population aged 〉20 vears old[4].