Treatment of the associated ulnar-sided problems

Abstract

Ulnar impaction, ulnar styloid impaction (USI), ligamentous injury, chondral lesions, associated TFC tear (triangular fibrocartilage) with or without instability [18-20], and sigmoid fossa derangements can all be associated with a radius malunion (Fig. 13.1). Although it is true that treatment of the radius malunion itself might partially correct some of the problems, particularly those caused by axial shortening (USI), many other will remain unaddressed, and will be a source of pain and patient dissatisfaction. On the other hand, the isolated treatment of the associated injuries can be sufficient to ease the patient's symptoms without addressing the radius, and a less involved postoperative course. Arthroscopic exploration allows the assessment of the impact that those associated injuries might have on the patient's symptoms and the degree of improvement by the radius osteotomy itself, and also helps to evaluate if additional maneuvers (arthroscopic or open) are needed for addressing concomitant injuries. © 2010 Springer-Verlag Berlin Heidelberg.