- See:
RU joint:
- Discussion:
- 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;
-
causes:
- 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;
- Radiographs:
- evaluated w/ pronated - clenched fist
PA;
- look for sclerotic changes in lunate and ulnar head;
- Treatment:
- 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.
Chun S, Palmer AK.
J Hand Surg. 1993: 18 (1): 46-53.
Precision oblique osteotomy for shortening of the ulna.
Rayhack JM, Gasser SI, Latta LL. J Hand Surg. 1993: 18 (5): 908-919.
Pre-osteotomy plate application technique for ulnar shortening.
