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Nonunion After Using Procedure-Specific Instrumentations for Ulnar Shortening Osteotomy
Alexis A Kasper1, Yashas Reddy1, Kyle Plusch1
1Rothman Orthopedic Institute at Thomas Jefferson University, Philadelphia, USA.
The Archives of Bone and Joint Surgery
|December 7, 2023
Summary
Transverse osteotomies showed higher nonunion rates after ulnar shortening surgery. Procedure-specific implants may reduce nonunion risks, but patients should be informed of potential secondary surgeries.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Ulnar shortening osteotomy (USO) is a surgical procedure to treat conditions like ulnar impingement.
- Assessing nonunion rates and implant performance is crucial for optimizing surgical outcomes.
Purpose of the Study:
- To compare nonunion rates across different osteotomy designs and implant brands.
- To evaluate reoperation and hardware removal rates following USO.
Main Methods:
- Retrospective cohort study of 92 patients undergoing USO (2015-2022).
- Inclusion criteria: skeletally mature patients diagnosed with ulnar impingement.
- Comparison of six brand-specific devices against conventional plate fixation.
Main Results:
- Overall bone union rate was 90% (83/92 patients).
- Transverse osteotomies were significantly associated with higher nonunion rates.
- A notable difference in union rates among implant brands was observed, though not statistically analyzed due to small group sizes.
Conclusions:
- Patients should be counseled on the nonunion risk and potential need for revision surgery.
- The use of procedure-specific devices may potentially lower the risk of nonunion after USO.
