Plate removal after ulnar-shortening osteotomy

Area of Science:

• Orthopedic surgery
• Hand and wrist surgery

Background:

• Ulnar-shortening osteotomy (USO) with plate fixation is common for wrist disorders.
• Prominent hardware can cause persistent discomfort, even after bone healing.

Purpose of the Study:

• To investigate the outcomes of plate removal in patients experiencing persistent symptoms after USO.
• To guide surgeons on the optimal timing for hardware removal.

Main Methods:

• Retrospective review of 40 USOs; 14 patients underwent plate removal due to persistent tenderness.
• Radiographic union confirmed by multiple X-rays at least 4 weeks apart before removal.
• Average time to plate removal was 6.6 months.

Main Results:

• All patients experienced resolution of ulnar forearm pain post-removal.
• No revision surgeries were needed; patients returned to previous activity levels.
• One case of refracture occurred in an osteoporotic patient 7 months after removal.

Conclusions:

• 3.5-mm compression plates used in USO for ulnar-sided wrist pain appear safely removable 6-9 months post-surgery.
• Symptomatic patients with confirmed radiographic healing have a low risk of refracture.
• Plate removal effectively addresses hardware-related discomfort following USO.