Wrist · Ulnar Sided
Ulnocarpal Impaction
Ulnocarpal impaction may occur when the distal ulna extends beyond the distal radius (ulnar positive variance). When this difference in lengths occurs, the ulna may impact the TFCC.
Call our office · (623) 264-3300The Pinching Phenomenon
Overview
How Ulnocarpal Impaction Develops
Ulnocarpal impaction may occur when the distal ulna extends beyond the distal radius (ulnar positive variance). When this difference in lengths occurs, the ulna may impact the TFCC.
The TFCC is compressed against the ulnar aspect of the lunate bone in the carpus. This pinching phenomenon may lead to a tear of the TFCC.
In addition, an MRI evaluation may demonstrate boney changes involving the ulnar aspect of the lunate.
What the TFCC Does
The TFCC sits on the pinky side of the wrist and acts as a cushion and stabilizer for the joint. When the ulna is longer than the radius, that cushion is repeatedly compressed — a mechanical pinch that can wear the tissue down and eventually tear it.
Read About TFCC InjuriesWhen to Seek Evaluation
If symptoms on the pinky side of your wrist persist or are not responding to conservative treatment, an evaluation can help determine whether ulnocarpal impaction is the cause.
Request an AppointmentTreatment Options
From Conservative Care to Surgery
When ulnocarpal impaction becomes symptomatic and is non-responsive to conservative treatment, your physician may discuss surgery involving shortening of the ulnar bone and treatment of the TFCC tear.
Conservative Treatment
When ulnocarpal impaction becomes symptomatic, conservative treatment may be trialed before surgery is considered. The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician.
Nonoperative treatment also carries risks and benefits which should be discussed with your treating physician.
Ulnar Shortening Osteotomy
This procedure reduces the length of the ulna and may help resolve symptoms that occur with impaction and pinching involving the TFCC and lunate bone.
- Shortening of the ulnar bone
- Treatment of the TFCC tear
- Aimed at resolving impaction and pinching symptoms
Risks & Benefits
Outcomes after surgical treatments vary and risks and benefits should be discussed in detail with your treating physician.
Nonoperative treatment also carries risks and benefits which should be discussed with your treating physician.
Pain on the Pinky Side of Your Wrist?
If symptoms have not responded to conservative treatment, an evaluation can help determine whether ulnocarpal impaction is the cause and which options are appropriate.
Request an AppointmentCommon Questions
Ulnocarpal Impaction FAQs
What is ulnocarpal impaction?+
Ulnocarpal impaction may occur when the distal ulna extends beyond the distal radius (ulnar positive variance). When this difference in lengths occurs, the ulna may impact the TFCC.
How does this lead to a TFCC tear?+
The TFCC is compressed against the ulnar aspect of the lunate bone in the carpus. This pinching phenomenon may lead to a tear of the TFCC.
What does imaging show?+
An MRI evaluation may demonstrate boney changes involving the ulnar aspect of the lunate.
What is an ulnar shortening osteotomy?+
When ulnocarpal impaction becomes symptomatic and is non-responsive to conservative treatment, your physician may discuss surgery involving shortening of the ulnar bone and treatment of the TFCC tear. This ulnar shortening osteotomy procedure reduces the length of the ulna and may help resolve symptoms that occur with impaction and pinching involving the TFCC and lunate bone.
Is surgery always needed?+
No. The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician.
Read more about TFCC injuries and scapholunate ligament injuries.
Precision Hand and Orthopedic Surgery
Ulnar-Sided Wrist Pain?
If pain on the pinky side of your wrist has not responded to conservative treatment, an evaluation with Tanay Amin, MD, FAAOS can identify the cause and help you understand your options.
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Disclaimer: This information is not intended to convey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/15/2021 Tanay Amin, MD. Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.