Ulnocarpal Impaction / Impingement Syndrome
- See: RU joint
- refers to impingement of the ulnar head against the carpi which can lead to TFCC tears and lunotriquetral ligament attrition;
- lunotriquetral ligament attrition may occur from compression and translation shear as the lunate becomes impinged against the ulnar head;
- distal radius frx w/ radial shortening (positive ulnar varience:);
- radial head excision
- Essex Lopresti frx
- Galeazzi frx
- Clinical Features:
- patients may note ulnar sided pain and swelling;
- evaluated w/ pronated - clenched fist PA;
- look for sclerotic changes in lunate and ulnar head;
- when ulnocarpal impaction occurs following frx either opening wedge radial osteotomy or ulnar shortening procedure is required;
- consider an oblique ulnar shaft osteotomy if joint incongruenty is present;
- consider resection arthroplasty strategy (Bower's or Darrach) if there is DJD in the DURJ;
- note: TFFC tear may also occur (and can mimic ulnocarpal impaction)
Wafer distal ulna resection for triangular fibrocartilage tears and/or ulna impaction syndrome.
The ulnar impaction syndrome: follow up note of ulnar shortening osteotomy.
Precision oblique osteotomy for shortening of the ulna.
Pre-osteotomy plate application technique for ulnar shortening.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Wednesday, December 12, 2012 2:40 pm