Ulnar-sided wrist pain is a common cause of upper extremity disability. Presentation can vary from acute traumatic injuries to chronic degenerative conditions. Because of its overlapping anatomy, complex differential diagnosis, and varied treatment outcomes, the ulnar side of the wrist has been referred to as the "black box" of the wrist, and its pathology has been compared with low back pain. Common causes of ulnar-sided wrist pain include triangular fibrocartilaginous complex injuries, lunotriquetrial ligament injuries, and ulnar impaction syndrome.
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Introduction: wrist ligament injuries and triangular fibrocartilage complex (TFCC) lesions are common but often underdiagnosed conditions causing chronic wrist pain. The diagnostic challenge necessitates a combination of clinical examination, imaging studies, and arthroscopy, considered the gold standard. Ligament injuries, particularly scapholunate ligament (SL), and TFCC lesions account for significant wrist instability and ulnar-sided wrist pain, respectively.
View Article and Find Full Text PDFFront-to-Back Arthroscopic Repair of Complete Lunotriquetral Ligament Injuries: A Case Presentation and Algorithm for Arthroscopic Management of Intercarpal Ligament Injuries.
J Hand Surg Am
December 2024
Division of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery, Emory University, Atlanta, GA. Electronic address:
The lunotriquetral intercarpal ligament (LTIL) is an important structure that equalizes the forces on the lunate imparted through the scapholunate intercarpal ligament. The extension moment of the triquetrum balances the flexion force of the scaphoid, positioning the lunate for efficient load transfer from the hand to the wrist. In contrast to the scapholunate intercarpal ligament, the LTIL is strongest volarly, with the most critical region being associated with the volar ulnocapitate ligament.
View Article and Find Full Text PDFArthroscopic algorithm for acute traumatic triangular fibrocartilage complex (TFCC) tears.
J Hand Microsurg
January 2025
Hand and Reconstructive Microsurgery, Olympia Hospital and Research Centre, Trichy, India.
The triangular fibrocartilage complex (TFCC) is crucial for stability and acts as a shock absorber and load transmitter at the distal radioulnar joint (DRUJ). It is often injured in wrist trauma, particularly in young athletes. Clinical assessment involves patient history, physical examination, and imaging modalities like MRI, with wrist arthroscopy as the gold standard for diagnosing TFCC tears.
View Article and Find Full Text PDFAn unstable distal radioulnar joint can cause ulnar-sided wrist pain. Stability of the distal radioulnar joint, which varies among individuals, is dependent on the bony structure of the sigmoid notch and the surrounding soft tissues, such as the interosseous membrane, the extensor carpi ulnaris tendon, the pronator quadratus, and the deep radioulnar ligaments. In particular, avulsions of the deep radioulnar ligaments lead to instability and disturbed wrist proprioception.
View Article and Find Full Text PDFThis study aimed to present the results of an alternative technique for treating ulnar impaction syndrome, the "reverse wafer procedure," and assess the mid-term clinical outcomes of patients treated with this technique. A retrospective evaluation was conducted on 14 patients who underwent the reverse wafer procedure for ulnar impaction syndrome between 2013 and 2020. The inclusion criteria for the study were persistent ulnar-sided wrist pain, even after a minimum of 3 months of nonoperative treatment, the presence of a chondral lesion on the lunate, and an intact triangular fibrocartilage complex (TFCC) based on arthroscopic evaluation.
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