Step-Cut Ulnar Shortening Osteotomy for Ulnar Impaction Syndrome.

Abstract

The step-cut ulnar shortening osteotomy for the treatment of ulnar impaction syndrome is a safe, reliable, and less expensive technique that uses a 7-hole 3.5-mm standard neutralization plate and a lag screw for fixation, thus avoiding the need for the special instrumentation that other ulnar shortening techniques require. Perform a physical examination and obtain imaging studies to identify all associated abnormalities. Verify the diagnosis of ulnar impaction syndrome and treat concurrent intra-articular abnormalities. Make a longitudinal skin incision along the distal third of the ulna. Design the step-cut ulnar shortening osteotomy. Create the step-cut ulnar shortening osteotomy using an oscillating saw. Fix the osteotomy with a lag screw and volar plate. Meticulously close the wound in layers. Protect the affected arm for the first 6 weeks. In our original study, 164 patients with symptomatic ulnar impaction syndrome were treated with a step-cut ulnar shortening osteotomy using a volar 3.5-mm standard neutralization plate and a lag screw¹⁴.