Abstract
PURPOSE: Ulnar shortening osteotomy (USO) is the primary surgical intervention for the treatment of ulnar impaction syndrome (UIS), requiring high precision. Conventional techniques face challenges in achieving optimal outcomes. This study evaluates whether 3D-printed patient-specific osteotomy guide plates can improve surgical precision and functional recovery. METHODS: A retrospective comparative study was conducted on patients who underwent USO, divided into the USO group (n = 37) and the 3D-USO group (n = 20). Perioperative outcomes, radiographic precision (ulnar variance and osteotomy angle), functional recovery (visual analog scale, disability of the arm, shoulder and hand, modified mayo wrist score, grip strength and range of motion) and medical cost were assessed. RESULTS: The 3D-USO group demonstrated significant advantages, including reduced operative time, fluoroscopy frequency and hospital stay. Radiographically, the 3D-USO group achieved superior precision in ulnar variance correction (-0.14 vs. -3.52 mm) and osteotomy angle (3.0° vs. 6.9°). Clinically, this group exhibited significantly better early functional recovery scores and grip strength at the 6 week and 3-month follow-ups. No significant difference was noted between the two groups in terms of the incidence of complications or the reoperation rates. CONCLUSION: 3D printed osteotomy guide plates improved surgical precision and early functional recovery without increasing postoperative risks. These findings corroborate the potential of the 3D-printed osteotomy guide plate as a translational and therapeutic tool for the effective, accurate, and personalised treatment of patients with UIS. LEVEL OF EVIDENCE: Level IV.