Ulnar Impaction Syndrome in Kennewick, WA
Restoring Wrist Balance: Ulnar Shortening Osteotomy with Dr. David W. Fischer, MD, FAAOS

When wrist pain interferes with your daily life, it’s time to seek expert care. At Benton Franklin Orthopedic Associates, Dr. David W. Fischer, MD, FAAOS, specializes in advanced procedures for complex wrist conditions, including ulnar shortening osteotomy—a surgical solution designed to restore balance and relieve pain in the wrist joint.
What Is Ulnar Impaction Syndrome?
Your forearm consists of two bones: the radius (thumb side) and the ulna (pinky side). In some people, the ulna is slightly longer than the radius, creating a condition called positive ulnar variance.
This imbalance can lead to ulnar impaction syndrome, where the ulna presses against the wrist bones and cartilage, causing:
- Persistent pain on the pinky side of the wrist
- Clicking or grinding during movement
- Difficulty gripping, lifting, or rotating the wrist
- Increased risk of cartilage wear and degenerative changes
What Is Ulnar Shortening Osteotomy?
Ulnar shortening osteotomy is a precise surgical procedure that involves removing a small section of the ulna and stabilizing the bone with a plate and screws.
This correction:
✅ Reduces pressure on the wrist joint
✅ Restores proper alignment between the radius and ulna
✅ Relieves pain and improves range of motion
✅ Prevents long-term joint damage

Who Is a Candidate for This Procedure?
You may benefit from ulnar shortening if you have:
- Ulnar impaction syndrome confirmed by imaging
- Pain that persists despite conservative treatments (splints, therapy, injections)
- Difficulty performing daily activities due to wrist discomfort

Dr. Fischer is board-certified by the American Board of Orthopedic Surgery with a Certificate of Added Qualification in Hand Surgery.
His approach combines:
- Advanced surgical techniques for precise bone alignment
- State-of-the-art fixation systems for optimal healing
- A patient-first philosophy focused on restoring function and reducing pain
While Dr. Fischer enjoys all aspects of general orthopedic surgery, his true passion lies in the intricate anatomy and function of the hand and wrist. “The human hand and wrist fascinate me most with their interactive parts and complex movements,” he shares. “It’s gratifying to help restore a patient’s ability to use their hands for daily activities, including work.” His patient-first philosophy is simple: “I like to think of my patients as part of my family, keeping their best interest foremost.”
He completed his residency and medical degree at Loma Linda University and is a Fellow of the American Academy of Orthopedic Surgery and a member of the American Association of Hand Surgeons. Outside the operating room, Dr. Fischer enjoys cycling and hobby farming, growing juice grapes and hay. His lifelong fascination with anatomy and surgery began in childhood, spending time in his father’s medical practice and observing hand surgeries during medical school.
Dr. Fischer specializes in the following orthopedic procedures and treatments: Hand Surgery, Elbow Surgery, Sports Medicine and Clinical Grade PRP/Regenerative Injection options.
If you are experiencing pain in your fingers or hand, call us at (509) 586-2828 or visit our Kennewick office to schedule your consultation. Feel free to visit up on the web at www.bfoaonline.com










