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Ulna shortening osteotomy (USO) is an acceptable procedure for TFCC tear, but is associated with a risk of delayed union or nonunion. The goal of this study was to characterize the utility of a new method to maintain and recover the periosteum at the osteotomy site in order to reduce the risk of such complications.

We retrospectively analyzed prospectively collected data from 85 patients (90 wrists) treated by USO for degenerative or traumatic TFCC tears between 2003 and 2009 in our hospital. Patients were categorized into two groups: 1) Group A consisted of 18 wrist in 18 males and 27 wrists in 26 females (average age, 41.3 years) who were treated with conventional methods and in whom the periosteum was locally detached for osteotomy and not recovered, and 2) Group B consisted of 16 hands in 16 males and 28 hands in 26 females (average age, 39.7 years) who were treated with the new methods in which the periosteum was detached minimally and recovered at the original site after plate fixation.

All osteotomy was performed in a transverse fashion and LC-DCP^Ⓡ was applied for fixation. The mean follow-up period was 38 months. Both groups were evaluated with radiographs every month. Osteotomy healing patterns were classified as follows: Type 1-1: no callus or bone absorption; Type 1-2: no callus and slight bone absorption; Type 2: callus formation at the osteotomy site; Type 3-1 healed with some bone absorption; and  Type 3-2: non-union with bone absorption.

 In Group A, there were four non-unions. The mean osteotomy healing time was shorter in Group B than in Group A (149.5 vs. 179.0 days; p=0.12). Osteotomy healing patterns (Group A vs. Group B) were as followed: Type 1-1 (7 vs. 16; p=0.04); Type 1-2 (7 vs. 9); Type 2 (9 vs. 8); Type 3-1 (18 vs. 12); Type 3-2 (4 vs. 0). Healing times averaged 100, 144, 157, and 226 days for Type 1-1, Type 1-2, Type 3-1, and Type 3-2, respectively.

Bone healing was superior and bone healing time was shorter with the new technique when compared with the conventional technique. This is likely due to that the periosteum provides blood supply and contains progenitor cells that developed into osteoblasts, thus indicates lower incidence of non-union or delayed union.