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Ulnar shortening osteotomy using the RECOS locking plate Surgical Technique

Overview

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CPD/CME Points: 1

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An ulnar shortening osteotomy is a common procedure in wrist surgery and was originally described by Milch in 1941 for the treatment of an ulnar positive variance following a distal radius malunion.

Currently it is performed for a variety of indications and although these may demand different degrees of shortening, the same techniques and instruments may be used to ensure a high degree of precision and control.

Recent years have seen a number of manufacturers introduce specialised instrumentation and customised plates.  In this section I describe one technique of ulnar shortening using the RECOS (KLS Martin Group, Germany) locking reconstruction system for ulnar shortening.

This is a pre-contoured titanium plate with drill sleeves and colour coded screws.

An adjustable jig allows the surgeon to perform a predetermined degree of shortening whilst two sliding holes allow compression across the osteotomy followed by lag screw placement and rigid fixation

It is one of a number of similar ulnar shortening plates used at our institution, and has a very limited number of instruments required. It is consequently one of the simpler procedures to follow.

 

Author: Tahseen Chaudhry, (FRCS Tr & Orth) Consultant Hand Surgeon

Institution: Birmingham Hand Centre, Queen Elizabeth Hospital Birmingham

 

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