Ulnar shortening osteotomy using the RECOS locking plate surgical technique
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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