The authors retrospectively reviewed the results of ulnar shortening osteotomy in 5 patients, 6 wrists, with neutral or negative ulnar variance. The average grip strength, wrist flexion and extension measurements, and Mayo wrist scores increased at a mean follow-up of 30 months (range, 11 - 48 months).
This study supports ulnar shortening osteotomy as a treatment for patients with ulnar impaction syndrome in association with neutral or negative ulnar variance. Ulnocarpal impaction can occur in these situations because of the inverse relationship between ulnar variance and triangular fibrocartilage complex thickness, and because ulnar variance is increased by forearm pronation and forceful grip. The ulnar seat and sigmoid notch inclinations are important to note when considering an ulnar shortening osteotomy, as a discrepancy in slopes may result in an incongruous distal radioulnar joint.
J Hand Surg