Ulnar Impaction Syndrome
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Search Strategy[edit | edit source]
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Definition/Description[edit | edit source]
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Epidemiology/Etiology[edit | edit source]
Asians have a higher incidence of ulnar variance than Whites, and since ulnar variance is a risk factor for ulnar impaction, ulnar impaction syndrome may be present more often in Asians. However, ulnar impaction is more commonly from an acquired variance rather than congenital. Acquired variance can be due to distal radial fracture malunion, radial head excision, premature physeal closure of the radius, and increased ulnar length. Any of these predisposing factors can lead to excess load across the ulnocarpal joint, resulting in ulnar impaction syndrome.
Characteristics/Clinical Presentation[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Outcome Measures[edit | edit source]
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Examination[edit | edit source]
To diagnose ulnar impaction syndrome, the PT can perform the following:
- Complete wrist exam
- Palpation
o Look for tenderness dorsally just distal to ulnar head
o Look for tenderness just volar to the ulnar styloid process
- Ulnocarpal stress test
o Place wrist in maximum ulnar deviation
o Apply axial load to wrist
o Passively rotate forearm through supination and pronation
o + Test = reproduction of patient’s pain
- Compare to contralateral wrist
- Imaging – check for ulnar variation
o Neutral rotation P-A radiograph with elbow in 90° flexion
o Pronated grip P-A radiograph
o May have subchondral sclerosis, cystic changes, or osteophyte formation
Medical Management
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Physical Therapy Management
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Key Research[edit | edit source]
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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