Abstract
Ulnar shortening osteotomy is an established and frequently performed surgical procedure
in wrist surgery. The technical aspects of the procedure have continued to develop
in recent years, with instruments and implants being developed specifically for this
purpose. Ulnar shortening osteotomy is required for different clinical indications
and situations. These varying indications demand different amounts of shortening,
but all must be precise and accurate. Controversy exists as to how this can best be
achieved in terms of the location for osteotomy, the surgical approach and geometry
of the osteotomy, as well as which implant to use to provide optimal stability. The
goal of all techniques (besides successfully resolving the underlying problem) is
to achieve reliable and rapid bone union without compromising early functional rehabilitation
and also to avoid hardware complications. The AO Hand Expert Group has developed a
specialized instrumentation system with dedicated and specifically designed implants
to ensure exact and accurate cutting with precise and rigid stabilization of the ulna.
The matched drill guides and double-blade saws allow accurate completion of the planned
amount of shortening together with precise coaptation of the osteotomy fragments.
The specific ulnar osteotomy LCP (locking compression plate) combines maximum stability
with minimum bulk and soft tissue irritation. The features of the implant, its surgical
technique, and early results are described.
Keywords
ulnar shortening - osteotomy - ulnocarpal impaction
