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Negative ulnar variance. Some Kienböck's patients present with an abnormally large difference in length between the radius and the ulna , termed " ulnar variance ", which is hypothesized to cause undue pressure on the lunate, contributing to its avascularity.
The load transmission is directly proportional to this ulnar variance. In neutral ulnar variance, approximately 20 percent of the load is transmitted. With negative ulnar variance, the load across the TFC is decreased. This occurs during supination, because the radius moves distally on the ulna and creates a negative ulnar variance.
There is an increased risk of interosseous intercarpal injury if the ulnar variance (the difference in height between the distal end of the ulna and the distal end of the radius) is more than 2mm and there is fracture into the wrist joint. [5] Triangular fibrocartilage complex (TFCC) injury occurs in 39% to 82% of cases.
Ulnar impaction syndrome is a painful condition of excessive contact and wear between the ulna and the carpus with an associated is a degenerative tear of the TFCC. Positive, neutral, and negative ulnar variance. Relationship between radial length and ulnar variance. Radial length is the measure from distal ulna to radial styloid process.
The ulnar nerve can suffer injury anywhere between its proximal origin of the brachial plexus all the way to its distal branches in the hand. It is the most commonly injured nerve around the elbow. [ 9 ] [ 10 ] Although it can be damaged under various circumstances, it is commonly injured by local trauma or physical impingement ("pinched nerve").
Injuries to the distal radioulnar articulation often result from falls onto an outstretched hand. Injury can occur with concurrent fracture of the distal radius, the ulna, or can be isolated. For the upper limit of the distal radioulnar distance, sources vary between 2 mm [ 6 ] and 5 mm. [ 7 ] A classification system has been proposed by ...
At this age, the relatively slower growth of the ulnar and palmar part of the radius, leads to an increasingly progressive deformity. Pain and deformity are the main symptoms patients present with. [1] Typical clinical presentation consists of a short forearm, anterior-ulnar bow of the radius and a forward subluxation of the hand on the forearm.
The Galeazzi fracture is a fracture of the distal third of the radius with dislocation of the distal radioulnar joint.It classically involves an isolated fracture of the junction of the distal third and middle third of the radius with associated subluxation or dislocation of the distal radio-ulnar joint; the injury disrupts the forearm axis joint.