Subcapital ulnar shortening osteotomy.

Ulnar shortening osteotomy is the standard treatment for the condition of ulnocarpal impaction. Traditionally ulnar shortening osteotomy has been performed in the diaphysis and secured with a 3.5 mm plate. Delayed union, nonunion, and symptomatic hardware have been cited as detractors of this technique. A number of alternatives have consequently been proposed that range from different hardware to different patterns of osteotomy to resection of the distal portion of the ulnar head. This article describes one method for ulnar shortening osteotomy that seeks to draw upon the advantages of several of these variations in order to minimize complications.