Lauder, A J, MD, Trumble, T E, MD
UW Medicine Department of Orthopaedics and Sports Medicine 2006 Research Report, 50-53.
The ulnar shortening osteotomy has become the gold standard for correcting positive ulnar variance. Ulnar variance is defined as the difference in length between the distal ulnar corner of the radius and the distal most aspect of the dome of the ulnar head. Positive ulnar variance occurs when the dome of the distal ulna is more distal than the ulnar corner of the distal radius. This positive variance leads to ulnar sided wrist pain and degenerative processes due to the overloading that occurs between the ulnar head and the ulnar capus. Thus, the goals of the shortening procedue are to relieve pain and prevent arthritis by reestablishing a neutral or slightly negative ulnar variance. The typical incidations for the osteotomy include ulnar impaction syndrome, non repairable tears of the triangular fibrocartilage complex (TFCC), previous radial head excision and associated Essex-Lopresti lesions, attritional luno-triquetral ligament tears, ulnar nonunions, radial malunions, and early post-traumatic distal radioulnar joing (DRUJ) arthritis. Numerous authors have introduced methods and systems for performing, and hopefully simplifying, the osteotomy. This study compared the results of shortening ulnas with a new plate and compresssion system to a previously described and accepted method.