Ulnocarpal Abutment Syndrome

What is Ulnocarpal abutment syndrome?

Ulnocarpal abutment syndrome is a painful wrist condition in which bones rub together abnormally in the wrist leading to arthritis. The ulna is the long forearm bone that runs from the tip of the elbow and ends at the small finger side of the wrist. The wrist end of the ulna can be too long and “abut” or rub against the other small carpal wrist bones damaging the cartilage and also tearing a ligament in the wrist called the triangular fibrocartilage complex (TFCC).

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Overview

Symptoms

Causes

Diagnosis

Your symptoms and medical history as well as an examination of your hand and wrist can help to diagnose ulnocarpal abutment. Special x-rays of the wrist will often show that the ulna is too long and may show signs of arthritis in the wrist. Occasionally we need an MRI of the wrist to diagnose and help guide treatment.

Why treatment matters

We start with nonoperative treatment options and progress to operative treatments if symptoms are persistent and severe enough to consider reconstruction.

Nonoperative

Activity modifications (avoid aggravating activities)
NSAIDS
Wrist bracing
Steroid injection

Operative

If the ulna is only slightly too long, sometimes we can shorten it using wrist arthroscopy techniques, where we place a small camera and instruments in the wrist joint, and the prominent end of the ulna is “shaved” down.

If the ulna is significantly too long, we often recommend a procedure called ulnar shortening osteotomy, where we make an incision along the forearm and surgical cuts in the bone to shorten it in the forearm. The cut ulna is then held back together with a metal plate and screws, which sometimes requires a second surgery for removal after the bone has healed.

Take the next step

Our board-certified specialists are here to help you heal. They can often diagnose the problem in one visit and get you started with a personalized treatment plan. We offer a wide variety of treatment options.