Arthrosopic Ulnar Styloidectomy for Ulnar Styloid Impaction Syndrome

  • Gregory I. Bain
  • Mario G. T. Zotti
  • Kevin Eng


Ulnar styloid impaction is characterized by the impaction of the triquetrum against the ulnar styloid causing chondromalacia, synovitis and ulnar-sided wrist pain. The causes are multiple but include any cause that brings the carpus closer to the ulnar styloid and vice versa.

There is a history of ulnar-sided wrist pain. On examination, pain is provoked by Ruby’s test. Plain radiographs may reveal a relatively long ulnar styloid process and progressive degenerative changes on the ulnar styloid and upon the triquetrum.

Treatment has been traditionally centred upon open ulnar styloidectomy as arthroscopic techniques were thought to place the triangular fibrocartilaginous complex at risk. A more recent arthroscopic technique is described that is effective whilst safe to ligamentous structures and with minimal postoperative morbidity for the patient.


Ulnar Nerve Distal Radius Fracture Ulnar Styloid Ulnar Variance Ulnar Head 
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  1. 1.
    Bain GI, Bidwell T (2006) Arthroscopic excision of ulnar styloid in stylocarpal impaction. Arthroscopy 22(6):677.e1–677.e3CrossRefGoogle Scholar
  2. 2.
    Bain GI, Munt J, Turner PC (2008) New advances in wrist arthroscopy. Arthroscopy 24(3):355–367PubMedCrossRefGoogle Scholar
  3. 3.
    Bickel KD (2008) Arthroscopic treatment of ulnar impaction syndrome. J Hand Surg Am 33(8):1420–1423PubMedCrossRefGoogle Scholar
  4. 4.
    Biyani A, Mehara A, Bhan S (1990) Morphological variations of the ulnar styloid process. J Hand Surg Br 15:352–354PubMedGoogle Scholar
  5. 5.
    Cantor R, Braunstein E (1987) Productive osseous changes about the wrist in rheumatoid arthritis. Skeletal Radiol 16:397–402PubMedCrossRefGoogle Scholar
  6. 6.
    Cerezal L, del Pinal F, Abascal F (2004) Magnetic resonance imaging findings in ulnar-sided wrist impaction syndromes. Magn Reson Imaging Clin N Am 12(2):281–299PubMedCrossRefGoogle Scholar
  7. 7.
    Cooney W (2010) The wrist: diagnosis and operative treatment, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, p 26Google Scholar
  8. 8.
    Garcia-Elias M (1987) Dorsal fractures of the triquetrum – avulsion or compression fractures? J Hand Surg Am 12(2):266–268PubMedGoogle Scholar
  9. 9.
    Giachino AA, McIntyre AI, Gui KJ, Conway AF (2007) Ulnar styloid triquetral impaction. Hand Surg 12(2):123–134PubMedGoogle Scholar
  10. 10.
    Giachino A, McIntyre A, Guy K, Conway A (2010) Ulnar styloid triquetral impaction: diagnosis and treatment. In: Slutsky D (ed) Principles and practice of wrist surgery, 1st edn. Elsevier/Saunders, Philadelphia, pp 511–522Google Scholar
  11. 11.
    Luchetti R, Borrelli PP (2010) Treatment of the associated ulnar-sided problems. In: del Piñal F, Mathoulin C, Luchetti R (eds) Arthroscopic management of distal radius fractures, First Editionth edn. Springer, Berlin/Heidelberg, pp 179–183Google Scholar
  12. 12.
    O’Rahilly R, Gardner E (1975) The timing and sequence of events in the development of the limbs in the human embryo. Anat Embryol 148(1):1–23PubMedCrossRefGoogle Scholar
  13. 13.
    Ogden J, Beall J, Conlogue G, Light T (1981) Radiology of postnatal skeletal development (IV – distal radius and ulna). Skeletal Radiol 6(4):255–266PubMedCrossRefGoogle Scholar
  14. 14.
    Scheuer L, Black S (2004) The juvenile skeleton, 1st edn. Academic, London, pp 286–287Google Scholar
  15. 15.
    Tomaino MM, Gainer M, Towers JD (2001) Carpal impaction with the ulnar styloid process: treatment with partial styloid resection. J Hand Surg Br 26:252–255PubMedGoogle Scholar
  16. 16.
    Topper SM, Wood MB, Ruby LK (1997) Ulnar styloid impaction syndrome. J Hand Surg Am 22(4):699–704PubMedCrossRefGoogle Scholar
  17. 17.
    Van der Heijden B, Groot S, Schuurman AH (2005) Evaluation of ulnar styloid length. J Hand Surg Am 30(5):954–959CrossRefGoogle Scholar
  18. 18.
    Zahiri H, Zahiri C, Ravari F (2010) Ulnar styloid impingement syndrome. Int Orthop 34(8):1233–1237PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Gregory I. Bain
    • 1
    • 2
  • Mario G. T. Zotti
    • 2
  • Kevin Eng
    • 3
  1. 1.Department of Orthopaedics SurgeryDiscipline of Anatomy and Pathology, University of AdelaideNorth TerraceAustralia
  2. 2.Department of Orthopaedics and TraumaRoyal Adelaide HospitalNorth TerraceAustralia
  3. 3.Department of OrthopaedicsModbury HospitalModburyAustralia

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