Ulna oblique osteotomy for radius and ulna length inequality: technique and applications.

An ulna that is too long or too short may be responsible for symptoms around the wrist. Several techniques are available to shorten or lengthen the ulna. We have used, among other techniques, an oblique osteotomy which allows the length of the ulna to be modified by sliding the 2 fragments over each other, taking care to keep good contact between them. The main advantage of this technique is that it combines length modification with a reorientation of the distal ulna, to restore congruency of the distal radioulnar joint. When shortening a long ulna, this may help to regain a normal range of pronation and supination. When used to lengthen a short ulna, it stabilizes the distal ulna stump, which may be a cause of pain if unstable and can impinge on the radius. This lengthening is combined with soft tissue procedures to further stabilize the distal stump.Our experience in using it for shortening was mainly in Madelung deformity and, for lengthening, the sequelae of too large a distal ulna resection.