Ulnar Shortening Osteotomy and Reduction Assisted by 3D-Printed Guide Plate and Predrilling Technique.

BACKGROUND

Ulnar shortening osteotomy (USO) is a common surgical procedure for ulnar impaction syndrome. However, some hospitals lack specialized USO plates, or patients decline them due to high costs. The freehand technique for USO lacks precision; therefore, we utilized 3D-printed guide plates to assist in performing USO and fixation with standard ulnar locking plates.

MATERIALS AND

METHODS

A retrospective case series of 87 patients was conducted using 3D-printed guide plates to achieve precise USO and fixation with standard ulnar locking plates. Primary outcomes included the patient-rated wrist evaluation (PRWE), disabilities of the arm, shoulder, and hand (DASH) questionnaire, and a custom patient satisfaction survey. Secondary outcomes included implant removal due to irritation and other complications.

RESULTS

The mean postoperative functional scores were 26 (standard deviation [SD]: 30) for PRWE and 21 (SD: 26) for DASH. Seventy-five patients reported satisfaction with the procedure. Thirty-six patients underwent implant removal due to irritation, with no plate fractures observed. One patient experienced nonunion, which healed after bone grafting, yielding a union rate of 98.9%.

CONCLUSION

This technique offers precise shortening and improved osteotomy angulation accuracy while increasing the contact area at the osteotomy site-theoretically reducing the nonunion rate. It is particularly suitable for hospitals without access to specialized USO plates.