Ulnocarpal Impaction/Abutment
Definition
Pain with ulnar deviation or loading activities associated with degenerative radiographic changes of the ulnar head and/or lunate/triquetrum and ulnar positive variance (increased ulnar length).
Symptoms
- Ulnar sided wrist pain at the DRUJ (distal radioulnar joint).
- Increases with ulnar deviation, loading, gripping and/or pronation activities.
Pathology
- Pathological changes due to impaction of the distal ulna upon the ulnar-sided carpal bones/navicular.
- Associated with ulnar positive variance (long ulna in relation to radius), TFCC tears and shortening of the radius from a prior fracture.
- Positive variance can be congenital or acquired secondary to trauma
Treatment
Non-surgical
- Rest, activity modifications, removable splint, ice and NSAIDs (ibuprofen)
- Corticosteroid injection
Surgical
- Indicated when non-operative treatment fails.
- Ulnar Shortening Osteotomy
- See Post-op Ulnar Shortening Osteotomy instructions for recovery information.