If I have Ulnar Impaction Syndrome, is an Ulnar Shortening Osteotomy my only option?

No!!  Over the past decade I have written about, and clinically advanced a minimally-invasive alternative approach----Arthroscopic TFCC debridement and wafer resection of the distal ulna. First, a cortisone injection may help, and I routinely see patients for this diagnosis who experience some improvement, at least temporarily. Second, though osteotomy techniques have improved over the past 5 years, there are still complications including nonunion, delayed union, pain at the residual distal radioulnar joint, and the need for plate removal.

There is really no reason not to try an Arthroscopic procedure unless the ulna is too long--more than 4-6 mm of positive variance, or when the ulnar styloid process is large, which may result in  "stylo-carpal' impingement. In these cases, it's best to proceed to a shortening osteotomy. However, it's important to carefully scrutinize the articular dimensions of the ulnar head and sigmoid notch to ensure that an articular "mismatch" will not result in joint pain after shortening.

Please copy and paste this link for more information including a narrated video of the procedure:

http://www.rearmyourself.com/article/treatment-of-ulnar-wrist-pain-with-arthroscopic-wafer-resection

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