Ulnar Resection Length: A Risk Factor for Nonunion in Ulnar Shortening Osteotomy

Author:

Pereira Gregory F.1ORCID,Fletcher Amanda N.1,O’Donnell Jeffrey A.1,Whitlock Keith G.1,Shapiro Lauren M.1,Pidgeon Tyler S.1ORCID,Ruch David S.1,Richard Marc J.1

Affiliation:

1. Duke University School of Medicine, Durham, NC, USA

Abstract

Background: Nonunion rates following ulnar shortening osteotomy (USO) are reported up to 18% with few known risk factors. While resection length is variable in practice, little is known about the prognostic implications on healing. The purpose of this study was to evaluate whether longer resection lengths increased the odds of nonunion. Methods: A retrospective review was performed on patients who underwent an elective USO at a single institution over a 6-year period. Demographic, social, comorbidity, and surgical data were reviewed. Ulnar resection length was obtained from operative notes and dichotomized into smaller (<5.5 mm) and larger (≥5.5 mm) groups. The primary outcome was the rate of nonunion. Univariate analyses and a multivariable logistic regression model were used to assess for significant predictors of nonunion. Results: A total of 87 patients were included with a mean age of 45 years. Patient comorbidities included 12.6% with diabetes, 29.9% with an American Society of Anesthesiologists score of ≥ 3, 5.8% reporting current tobacco use, and 29.9% reporting former tobacco use. There were 55 patients (63.2%) with resection lengths < 5.5 mm and 32 patients (36.8%) with ≥ 5.5 mm resections. Multivariable analysis identified longer resection length (≥5.5 mm) and current tobacco use as independent risk factors for nonunion. Patients with a resection length of ≥ 5.5 mm had 20.2 times greater odds of nonunion compared with patients with smaller resections, and current smokers had 72.2 times greater odds of nonunion compared with nonsmokers. Conclusion: Longer ulnar resection length (≥5.5 mm) significantly increases the risk of nonunion following USO.

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine,Surgery

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Non-Union nach Ulnaverkürzungsosteotomie;Handchirurgie Scan;2024-06

2. Guidelines for the Diagnosis and Treatment of Ulnar Impaction Syndrome (2024);Journal of Wrist Surgery;2024-05-27

3. Staple Fixation in Ulnar-Shortening Osteotomies;Journal of Hand Surgery Global Online;2023-07

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