Introduction and purpose: The ulnar carpal impaction syndrome (UCIS) is a common cause of pain in the ulnar aspect of the wrist. It has numerous causes, although most cases are due to rupture of the triangular fibrocartilaginous complex (TFC), either traumatic or degenerative.

Materials and methods: We carried out a prospective study of the results of ulnar shortening osteotomy in 41 wrists. The osteotomy (transverse) was performed in the middle third of the ulnar and the shortening ranged from 3 to 10 mm. For stabilisation we used a 3.5-mm AO LC-DCP and LCP plate. Minimum follow-up was 6 months and maxim was 8 years.

Results: The mean age was 37; there were 28 women and 12 men. The ulnar variance ranged from 5 mm positive to 2 mm negative. All the wrists had Tolat type I or II distal radioulnar morphology. Pain and pain frequency were reduced to levels below surgical indication in 89% of cases within 2 and 4 months after the operation. All the ulnae consolidated satisfactorily between 12 and 14 weeks, except for one case of pseudoarthrosis, which was treated with an iliac crest graft and further bone synthesis.

Conclusions: The results obtained in this series reveal adequate progression of wrist pain and function in patients treated for UCIS by ulnar shortening. There were very few complications and revisions.