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.

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.

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%.

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.

Received: 13 April 2025

Accepted: 01 July 2025

Article published online:
14 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA