{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:55:41Z","timestamp":1781801741558,"version":"3.54.5"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>The ulnar shortening osteotomy (USO) is a common procedure used to treat ulnar impaction syndrome secondary to static or dynamic ulnar-positive variance. There are many described techniques for the USO. The distal metaphyseal ulnar shortening osteotomy (DMUSO) with retrograde cannulated screw fixation was described to reduce complications seen with other techniques. Biomechanical analysis of fixation constructs demonstrates 2-screw constructs are significantly stiffer than 1 screw and antegrade constructs have similar or greater stiffness when compared with retrograde constructs. Here, we describe a technique of antegrade cannulated screw fixation for DMUSO that obviates the need for the disruption of the distal radioulnar joint for intra-articular exposure of the ulnar head. Similar to the traditional retrograde DMUSO technique, this construct may also decrease the risk of delayed union, symptomatic implants associated with diaphyseal osteotomies, and disruption of triangular fibrocartilaginous complex in wafer procedures.<\/jats:p>","DOI":"10.1097\/bth.0000000000000435","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T09:00:15Z","timestamp":1682586015000},"page":"182-188","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Antegrade Fixation of Distal Metaphyseal Ulnar Shortening Osteotomy"],"prefix":"10.1097","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6226-4701","authenticated-orcid":false,"given":"Joanne Y.","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery"},{"name":"Hand and Upper Extremity Surgery, Stanford University, Redwood City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S.","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery"},{"name":"Hand and Upper Extremity Surgery, Stanford University, Redwood City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalpit N.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Scripps Clinic, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Ostergaard","sequence":"additional","affiliation":[{"name":"Hand and Upper Extremity Surgery, Northwestern University, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery"},{"name":"Hand and Upper Extremity Surgery, Stanford University, Redwood City"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,9]]},"reference":[{"key":"R1-20250512","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/BTH.0b013e3180337df9","article-title":"Osteochondral shortening osteotomy for the treatment of ulnar impaction syndrome: a new technique","volume":"11","author":"Slade","year":"2007","journal-title":"Tech Hand Up Extrem Surg"},{"key":"R2-20250512","first-page":"00709","article-title":"Distal metaphyseal ulnar shortening osteotomy fixation: a biomechanical analysis","volume":"S0363-5023","author":"Frey","year":"2023","journal-title":"J Hand Surg"},{"key":"R3-20250512","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.jhsa.2016.01.005","article-title":"The \u201cfour-leaf clover\u201d treatment algorithm: a practical approach to manage disorders of the distal radioulnar joint","volume":"41","author":"Kakar","year":"2016","journal-title":"J Hand Surg Am"},{"key":"R4-20250512","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.hcl.2010.05.011","article-title":"Ulnar impaction","volume":"26","author":"Sammer","year":"2010","journal-title":"Hand Clin"},{"key":"R5-20250512","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1055\/s-0034-1384745","article-title":"Distal metaphyseal ulnar shortening osteotomy: technique, pearls, and outcomes","volume":"3","author":"Khouri","year":"2014","journal-title":"J Wrist Surg"},{"key":"R6-20250512","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1053\/jhsu.2000.jhsu025a0055","article-title":"Comparison of ulnar shortening osteotomy and the wafer resection procedure as treatment for ulnar impaction syndrome","volume":"25","author":"Constantine","year":"2000","journal-title":"J Hand Surg"},{"key":"R7-20250512","first-page":"124","article-title":"The \u201cwafer\u201d procedure. 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