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Background: Ulna shortening osteotomy is a common procedure for the surgical treatment of ulna impaction syndrome, but it is still associated with complications such as rotation malalignment, and delayed or non-union due to of incomplete closure of the osteotomy gap., Methods: We have developed a 7-hole titanium compression plate that provides fixation of the ulna before the osteotomy is carried out. With this plate, which has been in use for 4 years, a shortening of up to 10 mm is possible using two gliding holes, with the compression holes enabling the closure of the osteotomy gap. We report the results of 70 patients undergoing 70 ulna shortening procedures, with a follow-up of between 5 and 18 months. Two patient groups underwent follow-up clinical examination as well as completing the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire for evaluation., Results and Conclusions: There was no occurrence of delayed or non-union. The DASH score averaged 19 points in the prospective and 23 points in the retrospective group, representing a good functional result with only minor impairment. This study indicates that ulnar shortening using this gliding compression plate and performing an oblique osteotomy is associated with a minimal complication rate and highly satisfactory clinical outcome.

Ulna-shortening is a widely accepted procedure for the treatment of ulna-impaction syndrome. High rates of non-unions however necessitate improving the operation technique. The new device introduced in this study is a 7-hole plate in which two proximal holes are sliding-holes. By correct placement of two distal screws and two screws in the sliding-holes, rotational stability is guaranteed. The osteotomy is performed while the plate is loosely fixed to the ulna. After fixation of the two distal screws, the sliding-holes facilitate reposition with a good closure of the osteotomy gap. Excentric placement of two more screws and placement of a lag screw across the oblique osteotomy leads to further compression at the osteotomy site. Ulna-variance can be adjusted exactly. So far the plate has been implanted in 15 patients. Ulna-variance was reduced from + 2 to - 2.2 mm. The clinical results are comparable to those of ulna-shortenings in the literature. The sliding-hole plate allows an exact connection with good closure of the osteotomy without malrotation. With this simplified technique, the risk of non-union can be reduced.