Our Summary

This research paper talks about a common reason for pain on the side of the wrist, close to the ulna bone. The pain is caused by the ulna bone and a part of the wrist (lunotriquetral complex) pressing against each other. This pain usually occurs when the forearm is carrying weight or is being rotated. X-rays often show that the ulna bone is longer than usual, and there are cysts or fluid-filled sacs in one of the wrist bones. An MRI can also show swelling in the area where the ulna bone and the wrist bone meet. The paper suggests two types of surgery to reduce the load on the wrist bone and relieve the pain. One involves shortening the ulna bone, and the other involves a less invasive procedure using a small camera to guide the surgery.

FAQs

  1. What is ulnocarpal impaction syndrome and what causes it?
  2. What are the typical symptoms of ulnocarpal impaction syndrome?
  3. What are the different operative treatments for ulnocarpal impaction syndrome mentioned in the article?

Doctor’s Tip

A doctor might advise a patient undergoing wrist arthroscopy for ulnocarpal impaction syndrome to follow post-operative care instructions carefully, including keeping the wrist elevated and applying ice to reduce swelling and pain. They may also recommend gentle exercises and physical therapy to help regain strength and range of motion in the wrist. It is important for the patient to communicate any concerns or changes in symptoms to their doctor during the recovery process.

Suitable For

Patients who are typically recommended for wrist arthroscopy include those who have ulnocarpal impaction syndrome, also known as ulnar-sided wrist pain, caused by an abutment between the ulnar head and the lunotriquetral complex. These patients may have positive ulnar variance on radiographic examination, cysts in the lunate, and edema of the ulnoproximal lunate on MRI. Operative treatment options may include open ulnar shortening osteotomy or arthroscopic wafer procedure to reduce load on the lunate.

Timeline

Before wrist arthroscopy:

  1. Patient experiences ulnarsided wrist pain triggered by load bearing and rotation of the forearm.
  2. Radiographic examination shows positive ulnar variance and cysts in the lunate.
  3. MRI shows edema of the ulnoproximal lunate.
  4. Diagnosis of ulnocarpal impaction syndrome is made.
  5. Operative treatment options are discussed, including open ulnar shortening osteotomy or arthroscopic wafer procedure.

After wrist arthroscopy:

  1. Patient undergoes wrist arthroscopy procedure to reduce load on the lunate.
  2. Recovery period includes physical therapy and follow-up appointments with the surgeon.
  3. Pain and symptoms of ulnarsided wrist pain are expected to improve following the procedure.
  4. Patient may need to modify activities and follow post-operative instructions for optimal healing.
  5. Long-term follow-up may be necessary to monitor for any recurrence of symptoms.

What to Ask Your Doctor

  1. What specific symptoms indicate that wrist arthroscopy may be necessary for my ulnocarpal impaction syndrome?
  2. What are the potential risks and complications associated with wrist arthroscopy for ulnocarpal impaction syndrome?
  3. How long is the recovery time after wrist arthroscopy for ulnocarpal impaction syndrome?
  4. What are the expected outcomes and success rates of wrist arthroscopy for ulnocarpal impaction syndrome?
  5. Are there any alternative treatments or procedures that could be considered for my condition?
  6. How many wrist arthroscopy procedures for ulnocarpal impaction syndrome have you performed, and what is your success rate?
  7. Will I need physical therapy or rehabilitation after the wrist arthroscopy procedure for ulnocarpal impaction syndrome?
  8. What type of anesthesia will be used during the wrist arthroscopy procedure for ulnocarpal impaction syndrome?
  9. Will I need to make any modifications to my daily activities or lifestyle after the wrist arthroscopy procedure for ulnocarpal impaction syndrome?
  10. How long can I expect relief from symptoms after undergoing wrist arthroscopy for ulnocarpal impaction syndrome?

Reference

Authors: Leibig N, Lampert FM, Haerle M. Journal: Hand Clin. 2021 Nov;37(4):553-562. doi: 10.1016/j.hcl.2021.06.009. PMID: 34602135