Ulnar shortening

Ulnar shortening is a procedure that has steadily grown in popularity over the past decade. This technique was originally introduced to treat ulnar impaction following a displaced distal radial fracture. However, indications for ulnar shortening have increased over the years to include luno-triquetral tears and early degenerative arthritis at the distal radial-ulnar joint. Today the operation is more precisely performed due to technologic advances in surgical equipment. These advances include a specialized saw guide that allows the creation of perfectly parallel surfaces at known widths, a compression device that permits the osteotomy surfaces to be easily approximated with the plate already positioned on the ulna, and a specialized ulnar slotted plate that allows an interfragmentary screw to be placed through the plate at a 22 degrees angle. In addition to stainless steel, titanium plates are available to coordinate with standard screw sets that are made of titanium. Healing of the osteotomy is very reliable with the advent of precision oblique cuts. The major drawback to ulnar shortening is the potential need to remove the plate due to its palpable position along the ulnar subcutaneous border.