What is Ulnar Impaction Syndrome or Ulnar Abutment Syndrome?

Ulnar impaction syndrome is a degenerative condition of the human wrist which is also known as ulnar abutment syndrome or ulno carpal loading. This is a condition that causes the ulnar head to impact upon the ulnar-sided carpus causing injuries to the (TFCC) triangular fibrocartilage complex. In case of an elongated ulna bone chances are that the ulna and the radius will not be of the same length resulting in ulnar impaction syndrome or ulnar abutment syndrome. The term ‘ulnar plus variance’ is used to describe the abnormal length difference which is usually small. One is likely to experience severe pain in the wrist especially when the ulna is longer than the radius.

In most cases ulnar impaction syndrome or ulnar abutment syndrome affects the patients in their middle age but it can also be present from the time of birth. Research has proved that in most patients’ ulnar impaction syndrome or ulnar abutment syndrome occurs as a result of positive ulnar difference or increased dorsal tilt of the distal radius which may be present at birth or as a result of an earlier fracture, premature growth plate closure as well as radial head resection. In case of excessive repeated loading of the ulnar- carpus in everyday activities ulnar impaction syndrome or ulnar abutment syndrome is likely to occur.

This condition of ulnar impaction syndrome or ulnar abutment syndrome is diagnosed through clinical examination. It is also favored by radiographic studies. But in situations when nonoperative fails surgery is considered. The most important surgical options are partial resection of the distal dome of the ulna or ulnar shortening osteotomy.

What is Ulnar Impaction Syndrome or Ulnar Abutment Syndrome?

What Causes Ulnar Impaction Syndrome or Ulnar Abutment Syndrome?

The main cause of the ulnar impaction syndrome or ulnar abutment syndrome is an ulna that is longer than the radius resulting to the pinching of the triangular fibrocartilage and causes severe pain. As a matter of fact a person only develops the symptoms of ulnar impaction syndrome or ulnar abutment syndrome after an acute injury or a fall onto an outstretched hand in case they were born with congenital ulnar impaction syndrome or ulnar abutment syndrome.

What Causes Ulnar Impaction Syndrome or Ulnar Abutment Syndrome?

Is Ulnar Impaction Syndrome or Ulnar Abutment Syndrome Painful?

This condition of ulnar impaction syndrome or ulnar abutment syndrome causes pain due to the force exerted on the carpal bones of the hand as well as the cartilage that surrounds them due to length discrepancy of the ulna and the radius. The force destroys the cartilage which is alternatively referred as the TFC or triangular fibrocartilage complex resulting to severe pain and swelling on the outer side of the wrist. This is because TFC provides stabilizes the main joint of the wrist enabling it to operate with ease. But upon destruction the main joint cannot function effectively.

What are the Signs and Symptoms of Ulnar Impaction Syndrome or Ulnar Abutment Syndrome?

Ulnar impaction syndrome or ulnar abutment syndrome causes a lot of pain especially when the wrist is curved towards the little finger side or when one indulges in activities for instance push-ups. The ulnar side of the wrist may be tender and painful. In addition it causes the clicking and swelling of the wrist. One may also experience a lot of pain while gripping or grasping. However this condition can be treated. And you should seek medical attention in situations when the condition is beyond your control. For instance symptoms like fingernails that have changed colors to blue, gray and dark color.

Unexplained symptoms and pain and numbness in the hands are also a symptom of ulnar impaction syndrome or ulnar abutment syndrome.

What are the Risk Factors for Ulnar Impaction Syndrome or Ulnar Abutment Syndrome?

Below mentioned are the risk factors for ulnar impaction syndrome or ulnar abutment syndrome:

  • Sports activities for instance rowing, tennis, hockey, golf, pole vault and baseball are major risk factors for ulnar impaction syndrome or ulnar abutment syndrome. This is because they require recurring wrist and hand motion.
  • Weak hands and inflexibility is also a risk factor for ulnar impaction syndrome or ulnar abutment syndrome.
  • Poor sports mechanics as well as sports that require a lot of strength while loading at the hand and wrist.

What are the Complications in Ulnar Impaction Syndrome or Ulnar Abutment Syndrome?

There are few complications associated with ulnar impaction syndrome or ulnar abutment syndrome:

  • Recurring symptoms and a consequent injury that gives rise to a chronic problem is a complication of ulnar impaction syndrome or ulnar abutment syndrome.
  • Damage of other parts of the wrist or arthritis and the rigidity of the wrist.
  • Clicking or locking of the affected wrist.
  • Negative effects of surgery such as excessive bleeding, infection and injury to the nerves, repeated operation, excessive pain and locking or locking are complications of ulnar impaction syndrome or ulnar abutment syndrome.

How is Ulnar Impaction Syndrome or Ulnar Abutment Syndrome Diagnosed?

Ulnar impaction syndrome or ulnar abutment syndrome is gradual and harmful at the same time. In that case patients can have the syndrome despite the fact that they may not have the symptoms. However in other occasions the symptoms may be too obvious. The common symptoms of ulnar impaction syndrome or ulnar abutment syndrome are pain, excess watery fluid collecting in the tissues of the body occasionally, forearm inflexibility, decreased wrist ROM or range of motion as well as softness to palpation dorsally away from to the ulnar head and volar to the ulnar styloid process. The symptoms become worse due to forceful grip, ulnar deviation and forearm pronation.

During a physical examination for ulnar impaction syndrome or ulnar abutment syndrome the doctor checks the following:

  • They check the wrist for tenderness, swelling and abnormalities.
  • They examine the ROM or range of motion of wrist. In case it is a decreased range of motion then the patient might be suffering from ulnar impaction syndrome or ulnar abutment syndrome.
  • Examining the strength of the grip and forearm. But in other cases the doctor may decide to conduct some imaging tests.

Imaging tests for diagnosing ulnar impaction syndrome or ulnar abutment syndrome include:

  • X-rays are taken to diagnose ulnar impaction syndrome or ulnar abutment syndrome. These are excellent in revealing bone fractures and signs of osteoarthritis. This is possible through the use of little amount of radiation. In addition it is quite effective for testing pain.
  • CT scan is also used to confirm ulnar impaction syndrome or ulnar abutment syndrome. In some cases scan does not reveal some fractures despite the X-ray being termed excellent in revealing bone fractures. But a CT scan is used by the doctors to find such structures and provide a well-defined view of the bone in your wrist.
  • MRI provides detailed images of the bones and soft tissues. Actually this kind of test uses radio waves as well as a powerful magnetic field. As a matter of fact a doctor can use a wrist MRI where a patient is needed to insert an arm into a smaller device instead of the whole body. MRI machine.
  • Ultrasound tests might be conducted to diagnose ulnar impaction syndrome or ulnar abutment syndrome. This test does not involve the insertion of the instrument in the body. But it is effective in visualizing tendons, ligaments as well as cysts.

Arthroscopy to Diagnose Ulnar Impaction Syndrome or Ulnar Abutment Syndrome

Arthroscopy to test ulnar impaction syndrome or ulnar abutment syndrome is the last option and it is only opted in case all the other tests give results that are not clear. Actually the doctor inserts an arthroscope into the patients’ wrist through a small incision in the skin. The instrument has a light and a small camera. Once it is inserted in the wrist, it projects images onto a monitor. As a matter of fact an arthroscopy for ulnar impaction syndrome or ulnar abutment syndrome is a super effective method for evaluating long term wrist pain.

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Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: August 30, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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