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Effect of preservation of corticoperiosteal attachment on bone healing at osteotomy sites after ulna-shortening osteotomy

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HAND

Type of study/level of evidence Therapeutic IV

Abstract

Background

Although precise ulna-shortening osteotomy is popular, the procedure sometimes results in delayed union or nonunion. The periosteum including the inner cambium layer plays an important role in fracture healing. We tested the hypothesis that preservation of the corticoperiosteal attachment may accelerate healing at osteotomy sites after ulna-shortening osteotomy.

Methods

We performed a chart review of 32 patients who underwent ulna-shortening osteotomy for ulnar impaction syndrome or triangular fibrocartilage complex tears in a retrospective single-surgeon series. Of the 32 cases, the periosteum was preserved in 21 osteotomies performed from April 2009 onwards (periosteum-preserved group) and not preserved in 11 osteotomies performed before April 2009 (control group). Following sugar tong immobilization, patients in both groups used a short wrist supporter during the first two postoperative weeks (POW) and up to at least four POW. Union of the osteotomy site was assessed at 2-week intervals using radiographs taken at three different projections until 12 POW and at 4-week intervals thereafter until 24 POW. Ulna shortening was performed using a transverse osteotomy cut with the aid of a commercially available compression device.

Results

All osteotomies achieved complete union except in one case in the control group. The mean interval to complete cortical union was 7.7 weeks in the periosteum-preserved group and 9.5 weeks in the control group. The corresponding mean times for endosteal union were 15.6 and 21.8 weeks. The periosteum-preserved group had reduced times for both types of union but only the endosteal union time was significantly different from the control group.

Conclusions

Preservation of the corticoperiosteal attachment significantly shortened the endosteal union time. Our results indicate that preservation of the periosteum may accelerate bone healing after ulna-shortening osteotomy.

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Acknowledgments

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

Conflict of Interest

Yoshitaka Hamada declares that he has no conflict of interest.

Koichi Sairyo declares that he has no conflict of interest.

Naohito Hibino declares that he has no conflict of interest.

Ryosuke Sato declares that he has no conflict of interest.

Anna Kobayashi declares that he has no conflict of interest.

Statement of Human and Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation 140 (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008

Statement of Informed Consent

Identifying information, including patients’ names, initials, or hospital numbers, was not published in written descriptions, photographs, and pedigrees.

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Authors and Affiliations

  1. Department of Orthopedics, Tokushima Prefectural Central Hospital, 1-10-3, Kuramoto-cho, Tokushima, 770-8539, Japan

    Yoshitaka Hamada & Anna Kobayashi

  2. Department of Orthopedics, Institute of Health Biosciences, Graduate School, The University of Tokushima, Tokushima, Japan

    Koichi Sairyo & Ryosuke Sato

  3. Hand Center, Tokushima Prefectural Naruto Hospital, Tokushima, Japan

    Naohito Hibino

Authors
  1. Yoshitaka Hamada
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  2. Koichi Sairyo
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  3. Naohito Hibino
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  4. Anna Kobayashi
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  5. Ryosuke Sato
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Correspondence to Yoshitaka Hamada.

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Hamada, Y., Sairyo, K., Hibino, N. et al. Effect of preservation of corticoperiosteal attachment on bone healing at osteotomy sites after ulna-shortening osteotomy. HAND 10, 105–110 (2015). https://doi.org/10.1007/s11552-014-9662-6

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  • DOI: https://doi.org/10.1007/s11552-014-9662-6

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