INTRODUCTION: The purpose of this study is to examine Isolated Lunotriquetral Interosseous Ligament Tears treated by Ulnar Shortening Osteotomy and variables causally related to the diagnosis. METHOD: All patients not responding to conservative management of ulnar sided wrist pain (wrist x-rays and splinting) underwent bone scan, arthrogram and arthroscopy to confirm the presence of an isolated tear of the lunotriquetral interosseous ligament. All were treated with ulnar shortening osteotomy; in most cases, 2.5mm of ulna was removed. RESULTS: 58 patients were treated in this fashion. Pre-op ulnar variance was positive in 41, neutral in 12, negative in 5. Mean pre-op grip strength increased from 52 lbs. to a mean post-op strength of 68 lbs. The mean bone healing time was 17 weeks post osteotomy. There were no non-unions or complications. Variables having a high degree of association with LTL tears are; mechanism of injury and positive ulnar variance. Also frequently seen was ulna sided wrist pain radiating to the ring and little fingers. A loaded dorsiflexion wrist injury was the greatest precipitating injury, commonly seen with MVA’s. Follow-up was completed in 48 patients post-Ulnar Shortening Osteotomy. Results were graded using Chun and Palmers revised grading system. There were 17 excellent, 22 good, 9 fair and no poor outcomes. CONCLUSION: This study demonstrates ulnar shortening osteotomy to be an effective form of treatment for Isolated interosseous lunotriquetral ligament tears. Ulnar shortening is not effective when L-T tears are accompanied by a mid carpal instability or lunotriquetral osteoarthritis. The surgeon should maintain a high degree of suspicion for LT ligament tears when treating patients with ulnar sided wrist pain following an MVA or dorsiflexion injury, particularly when accompanied by ulnar positive variants.