This is a retrospective analysis of patients with ulnar impaction syndrome, who were diagnosed by wrist arthroscopy and treated by simultaneous ulnar shortening osteotomy.

Six patients with ulnar impaction syndrome, in whom there was an arthroscopic diagnostic confirmation of the disease had an arthroscopic debridement and ulnar shortening osteotomy. Conservative treatment over a period of more than six months had failed in each patient. The minimum duration of the follow up was one year. The ulnar variance was measured using Kreder's method, and the results were clinically analysed using Chun and Palmer's wrist score as well as radiographically.

The Palmer's stages of TFCC injury were 2A (one), 2B (four), 2C (one) on arthroscpic finding. The results were excellent in 4 and good in 2 (preoperative: 3 were fair, and 3 were poor). The wrist score increased from 63 to 94. The ulnar variance changed from +3 mm to -1 mm.

When an ulnar impaction syndrome is suspected on clinical grounds and by radiographic findings, the pathoanantomy should be assessed arthroscopically. If the arthroscopy reveals Palmer's stages 2A, 2B, 2C, arthroscopic debridement and ulnar shortening osteotomy is a useful method for the treatment of ulnar impaction syndrome.