title: Arthroscopic wafer procedure for ulnar impaction syndrome.
abstract: Ulnar impaction syndrome is abutment of the ulna on the lunate and triquetrum that increases stress and load, causing ulnar-sided wrist pain. Typically, ulnar-positive or -neutral variance is seen on a posteroanterior radiograph of the wrist. The management of ulnar impaction syndrome varies from conservative, symptomatic treatment to open procedures to shorten the ulna. Arthroscopic management has become increasingly popular for management of ulnar impaction with ulnar-positive variance of less than 3 mm and concomitant central triangular fibrocartilage complex tears. This method avoids complications associated with open procedures, such as nonunion and symptomatic hardware. The arthroscopic wafer procedure involves debridement of the central triangular fibrocartilage complex tear, along with debridement of the distal pole of the ulna causing the impaction. Debridement of the ulna arthroscopically is taken down to a level at which the patient is ulnar neutral or slightly ulnar negative. Previous studies have shown good results with relief of patient symptoms while avoiding complications seen with open procedures.
authors.affiliation: Carolinas Medical Center, Charlotte, North Carolina, U.S.A.
authors.forename: Julie
authors.initials: J
authors.lastname: Colantoni
authors.affiliation: OrthoCarolina, Charlotte, North Carolina, U.S.A.
authors.forename: Christopher
authors.initials: C
authors.lastname: Chadderdon
authors.affiliation: OrthoCarolina, Charlotte, North Carolina, U.S.A.
authors.forename: R Glenn
authors.initials: RG
authors.lastname: Gaston
references.citation: J Hand Surg Am. 1996 May;21(3):406-11
references.pmid: 8724470
references.citation: Am J Orthop (Belle Mead NJ). 2001 Feb;30(2):129-33
references.pmid: 11234939
references.citation: J Hand Surg Am. 2000 Jan;25(1):55-60
references.pmid: 10642473
references.citation: J Hand Surg Am. 2012 May;37(5):1071-7
references.pmid: 22541156
references.citation: Clin Orthop Relat Res. 1984 Jul-Aug;(187):26-35
references.pmid: 6744728
references.citation: J Hand Surg Am. 1981 Mar;6(2):153-62
references.pmid: 7229292
references.citation: Hand Clin. 2005 Nov;21(4):567-75
references.pmid: 16274867
references.citation: Tech Hand Up Extrem Surg. 2007 Mar;11(1):74-82
references.pmid: 17536528
references.citation: J Hand Surg Am. 2004 May;29(3):406-11
references.pmid: 15140481