ULNAR SHORTENING OSTEOTOMY IN POSTTRAUMATIC ULNAR IMPACTION SYNDROME

Twenty-eight patients (average age 45 years) with posttraumatic ulnar impaction syndrome underwent ulnar shortening osteotomy of 3-15 mm. Co ntributing factors were malunited fractures of the distal radius in 20 , diaphyseal fractures of the ulna and radius in 6, resection of the r adial head and a traumatic tear of the triangular fibrocartilage in 1 patient each. Evaluation at an average follow-up of 20 months showed a high rate of satisfied patients (89%), but according to Chun's modifi cation of the Gartland-Werley score there were 1 excellent (3.5%), 11 good (39.5%), 11 fair (39.5%) and 5 poor (17.5%) results. Degenerative changes of the distal radioulnar joint were associated with fair and poor results, and ulnar shortening osteotomy is only recommended in ul nocarpal impaction with an intact distal radioulnar joint. Osteotomy f ixation with 3.5 mm dynamic compression plates enabled immediate posto perative mobilisation and resulted in a low complication rate. There w as no advantage for the technically more demanding oblique as compared with a transverse osteotomy.