Risk Factors for Complications in Ulnar Shortening Osteotomies: A Multicenter Retrospective Review

Area of Science:

• Orthopedic surgery
• Hand and wrist surgery
• Surgical outcomes

Background:

• Ulnar shortening osteotomy (USO) is a common procedure for ulnar-sided wrist pain.
• Complications such as nonunion and hardware removal can occur, impacting patient outcomes.

Purpose of the Study:

• To determine the overall complication rate of USO.
• To identify risk factors associated with USO complications, including nonunion and hardware removal.

Main Methods:

• Retrospective multicenter cohort study over 6 years.
• Inclusion of 361 USOs with data collection on demographics, surgical technique, and complications.
• Statistical analysis using univariate and multivariable logistic regression to identify risk factors.

Main Results:

• Overall complication rate was 37.1%, with hardware removal at 29.6% and nonunion at 9.4%.
• Workers' compensation claims were risk factors for hardware removal (OR=3.81) and nonunion (OR=2.88).
• Younger age (OR=0.98) and male sex (OR=2.49) were risk factors for hardware removal and nonunion, respectively. Direct ulnar plate placement significantly increased hardware removal risk (OR=9.93).

Conclusions:

• USO is associated with substantial complication rates.
• Direct ulnar plate placement should be avoided to minimize hardware removal risk.
• Comprehensive patient counseling regarding USO risks is essential.