Arthroscopic Distal Ulna Wafer Resection

This patient complained of pain over the small finger (ulnar) side of his wrist, worse with gripping activities.  The X-rays reveal that the ulna is longer than the radius (ulna + variance) at the level of the wrist.  Though that does not cause symptoms in many patients, and for that reason does not require treatment, he developed ulna impaction syndrome as seen in the drawing.

He was treated by removing the very end of the ulna arthroscopically, with a burr.  This shortening of the ulna and elimination of the ulna + variance, cured his symptoms.  On the arthroscopic picture, the partially resected distal ulna (blue dot) is visible through the hole in the TFCC.  After the ulna is shortened with the burr, the X-rays reveal the change in the ulna variance (blue arrow).