ulnar sided wrist pain

Question 1

what are the causes of ulnar sided wrist pain

Answer 1

• ECU
• ulnocarpal abutment
• TFCC tear
• DRUJ arthritis
• hook of hamate fracture

Question 2

what are the components of the TFCC?

Answer 2

• dorsal/ palmar radioulnar ligaments
• articular disc
• meniscus homologue
• ECU
• ulnar collateral ligaments
• ulnolunate and ulnotriquetral ligament origins

Question 3

how do you distinguish between causes of ulnar sided wrist pain?

Answer 3

ECU
- instability - rotation
- pain on extension with UD

TFCC
- fovea test
- pain on UD

Ulnocarpal abutment
- ulnar stress test - pronation, UD, axial stress and flexion/ extension

Question 4

Treatment of TFCC tears

Answer 4

Degenerative tears
- arthroscopic debridement
- wafer procedure
- ulnar shortening if positive variance

Traumatic tears
- acute repair - peripheral tears (heal)
- debridement - central tears (don’t heal)

Question 5

DRUJ arthrosis

Answer 5

Treatment options
- darrach procedure - ulnar head resection
- sauve-kapandji - distal radioulnar fusion
- ulnar head replacement
- partial ulnar resection