Signs & Symptoms
These changes may produce pain, swelling, tenderness, thickening and/or stiffness in the overlying tissues of the wrist. The range of motion may become restricted. Many individuals with Kienböck Disease have a shorter ulna than radius (negative ulnar variance).
What is the significance of ulnar variance?
Ulnar variance is a measurement that is taken from X-rays to define the length of the ulna bone relative to the radius. This is an important measurement because the dynamics of the wrist are dependent on the ulna and radius translating force through the wrist.
How is ulnar variance treated?
Ulnar shortening osteotomy (USO) is the standard procedure for correcting positive ulnar variance. Goal of this procedure is to minimize the symptoms by restoring the neutral radio – ulnar variance.
What is normal ulnar variance?
– mean ulnar variance is 0.9 mm (range: 4.2 to 2.3 mm); – functional anatomy: – w/ neutral variance, 80% of load is born by radius and 20% by ulna; – 2.5 mm increase in ulnar varience will increase load borne by ulno-carpal joint from 18% to 42%;
Is a negative ulnar variance serious?
Many carpal instabilities present with subtle radiographic findings requiring careful evaluation of radiographs. Patients with negative ulnar variance and histories suggestive of ligamentous instability should undergo careful radiologic evaluation to assure early diagnosis of carpal disruption.
Is Kienböck’s disease curable?
Although there is no complete cure for Kienböck’s disease, there are several nonsurgical and surgical options for treating it. Treatment strategies consider the stage of the condition and the patient’s symptoms.
Is positive ulnar variance normal?
Ulnar variance may be: neutral (both the ulnar and radial articular surfaces at the same level) positive (ulna projects more distally) negative (ulna projects more proximally)
Does positive ulnar variance require surgery?
The debridement of the ulna is performed to the degree at which the patient is ulnar neutral or slightly ulnar negative. The benefit of this procedure is that open surgery is not required, and recovery is faster. However, if the ulnar variance is greater than +4mm, this option is not suitable.
What happens when your ulna bone is too long?
Ulnar impaction syndrome is a condition in which one of the forearm bones (ulna) is too long relative to the other (radius). This results in excessive pressure on the ulnar side of the wrist and causes pain, and wear and tear.
What is mild positive ulnar variance?
Positive ulnar variance describes where the distal articular surface of the ulna is more than 2.5mm distal to the articular surface of the radius. It plays important role in wrist pathology such as ulnar impaction syndromes and thinning of the triangular fibrocartilage complex.
What is ulnar wrist pain?
Overview. Ulnar wrist pain is pain on the side of your wrist opposite the thumb. This pain can vary, depending on the cause. It may worsen when you grip something or twist your wrist. Ulnar wrist pain can be hard to diagnose because it can be linked to many different types of injuries.
Is neutral ulnar variance good?
The variance could be neutral, positive and negative. It is said to be neutral if articular surfaces of radius and ulna are at the same level i.e. the difference between ulnar and radial length is
Is neutral ulnar variance normal?
The mean normal ulnar variance in neutral rotation was +0.74+/-1.46 mm, a value which was significantly lower in males than in females. We found negative variance in 26% of cases.
What does ulnar impaction feel like?
Common symptoms are: pain, occasional edema, decreased wrist range of motion, decreased forearm rotation, and tenderness to palpation dorsally just distal to the ulnar head and just volar to the ulnar styloid process. The symptoms are commonly aggravated by forceful grip, forearm pronation, and ulnar deviation.
How is ulnar impaction syndrome treated?
The basis of treatment of ulnar impaction1 is mechanical decompression of the ulnocarpal articulation by decreasing ulnar variance. Shortening of the ulna or resection of the distal ulna significantly decreases forces across the ulnar wrist.
What causes TFCC tear?
There are two main causes of TFCC tears: Injury: The force of falling on your hand or wrist can tear your TFCC. A fall or other injury that fractures your radius can also tear your TFCC. A sudden twist of your arm that over-rotates your wrist can also cause a TFCC tear.
