Class IIA and B Ulnar Impaction: Treatment with Arthroscopic TFCC Disc Excision and Wafer Distal Ulna Resection

Author(s):  
Matthew M. Tomaino
Keyword(s):  
1999 ◽  
Vol 24 (6) ◽  
pp. 671-675 ◽  
Author(s):  
M. M. TOMAINO

Thirteen wrists with ulnar neutral or negative variance were treated by open distal ulna excision (the wafer procedure). The mean follow-up was 25 months (range, 12–38). At final follow-up grip strength had increased a mean of 14 kgf and 12 of the 13 patients were very satisfied with the functional outcome and pain relief. In treatment of the ulnar impaction syndrome, the wafer procedure provides excellent pain relief and functional restoration particularly in patients with ulnar neutral or negative wrists in whom triangular fibrocartilage tears have not yet developed.


Hand Clinics ◽  
1998 ◽  
Vol 14 (2) ◽  
pp. 177-190
Author(s):  
Keith B. Raskin ◽  
Steven Beldner

Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
Anthony L. Logli ◽  
Beth A. Schueler ◽  
Laurel A. Littrell ◽  
Sanjeev Kakar

Background We hypothesize that different positions of the wrist in the coronal plane makes the carpus susceptible to ulnar impaction. Methods We prospectively enrolled 10 adult volunteers and obtained fluoroscopic images of each wrist in 12 different positions using a standardized protocol. Distances from the ulna to the lunate (UL) and ulna to the triquetrum (UT) were digitally measured as was the portion of the lunate surface area that was uncovered (LUR) with wrist deviation. Results A wrist position of Pronation, Neutral Deviation, and Grip (P-ND-G) significantly shortened the ulnocarpal distance when compared to a position of Neutral Rotation, Neutral Deviation, and No Grip (NR-ND-NG). Radial deviation during pronation and gripping (Pronated, Radial Deviation, Gripping [P-RD-G]) resulted in the lowest mean UL distance (1.2 mm). UT distance was minimized by a position of ulnar deviation during a pronated grip (Pronated, Ulnar Deviation, Gripping [P-UD-G]) (3.1 mm). The lunate becomes more uncovered with radial deviation. Conclusion Radial deviation minimizes the UL distance while ulnar deviation minimizes the UT distance during a wrist position of pronation and gripping. Further, there is more proximal lunate surface area uncoverage during all positions of radial deviation compared to ulnar deviation.


Hand Clinics ◽  
1998 ◽  
Vol 14 (2) ◽  
pp. 213-229
Author(s):  
Eial Faierman ◽  
Jesse B. Jupiter
Keyword(s):  

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