Ulnar Shortening Osteotomy

UW Health · UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation

Weight-Bearing

NWB surgical UE

Key Restrictions

No lifting/pushing/pulling/gripping Phase I; no lifting/pushing/pulling through Phase III; no sports or manual labor until 12 weeks with MD approval; no lifting >10 lbs, no sustained grip with counter resistance (hammering, drilling, digging, tennis, golf, racquetball) without MD approval; if concurrent TFCC repair, follow TFCC repair protocol; avoid aggressive stretching/strengthening

Timeline & Phases

Phase I (7-14 days): muenster orthosis, AROM shoulder/elbow/fingers/thumb, gentle short-arc wrist AROM progressing to mid-range; Phase II (4 weeks): progress to full wrist AROM held at end range 30-sec, muenster continues; Phase III (6 weeks): initiate gentle forearm AROM, progress AAROM wrist, OTS wrist orthosis, light ADL; Phase IV (8-12 weeks): AAROM forearm, hand strengthening (rubber bands/putty), light weights (1-3 lbs) for elbow/wrist, isometrics in neutral only for forearm, wean orthosis

Notes

UW Health / UnityPoint Health - Meriter Rehabilitation; OT-based; indicated for positive ulnar variance (ulnar impaction syndrome), ulnocarpal instability, or TFCC injury; osteotomy with compression plate at 3-4 cm proximal to sigmoid notch; create bump-out in thermoplastic orthosis to protect ulnar styloid process; if concurrent TFCC repair, defer to TFCC repair protocol; forearm supination facilitated with elbow flexed; pronation facilitated with elbow extended ~-30°; wrist widget/Modabber for forearm ROM support; no torque at wrist; avoid aggressive stretching — surgery goal is pain elimination

Surgeon / Author

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation