Hand Conditions

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