Ulnar shortening for tears of the triangular fibrocartilaginous complex

Ten consecutive patients had their ulnas shortened for treatment of ulnar wrist pain associated with triangular fibrocartilaginous complex tears. Each injury was traced to a previous fall or an overuse syndrome. Conservative treatment failed. In all patients, x-ray films showed ulnar positive or neutral variance. The ulna was shortened an average of 2 mm. Frank ulnolunate abutment and/or cartilage degeneration was found in six cases. Follow-up averaged 23 months, and except for one patient in whom radiocarpal arthritis developed, the remaining patients were satisfied and returned to their work or previous level of activity. Relief of pain, grip strength, and range of motion were excellent, except for an average decrease in flexion of 25.8 degrees (p = 0.01). Hardware irritation was noted in six patients. These findings substantiate the use of ulnar shortening to relieve ulnolunate impingement in patients with ulnar positive or neutral wrists in whom ulnar wrist pain develops and who demonstrate triangular fibrocartilaginous complex tears after acute trauma and/or overuse syndromes.