At 33 months postoperatively, pain score improved from 8.4 to 3.3, range of motion improved significantly, wrist and elbow functional scores were good, and positive ulnar variance
improved from +8.0 to 3.5 mm.
Radiographs shown in Figure 1 revealed neutral ulnar variance
, and sclerosis with indentation of the ulnar side of the proximal articular margin of the left lunate, consistent with ulno-lunate impaction syndrome.
APTUS Injured side 2.25 9.12 [+ or -] 5.28 Anatomical 0.00 12.00 [+ or -] 0.00 standard p value <0.05 <0.05 XSCR Injured side 2.96 9.11 [+ or -] 14.10 Anatomical 0.00 12.00 [+ or -] 0.00 standard p value 0.39 * <0.05 Group Extremity Ulnar variance
(mm) Articular surface step-off (mm) Mean [+ or -] S.D.
Overall there was a significant improvement in the position of the fracture, in both the degree of dorsal angulation and the degree of ulnar variance
One year after the treatment, reduced supination with positive ulnar variance
of 2mm was seen in two patients (8%); only one had ulnar sided pain and was offered surgical ulnar shortening which she refused.
Radial length was restored in all cases; ulnar variance
averaged 0 mm.
There was no association of primary osteoarthritis of the DRUJ with ulnar variance
Plain radiograph of the left wrist revealed sclerosis, fragmentation and collapse of lunate bone with normal ulnar variance
and normal radiolunate articular surface.
(9) In addition, dynamic wrist instability has been shown to result from an underlying ligament injury associated with wrist ganglions, lifting and twisting manoeuvres, overuse of the wrist, arthritis, positive ulnar variance
, and perilunate or reverse perilunate injury.
Radiographic evaluation consisted of an anteroposterior and lateral film with the following parameters obtained at baseline and each study visit: dorsal and palmar tilt, radial height, radial inclination, ulnar variance
, and osteoarthrosis (OA) grade based on the Knirk and Jupiter scale.
An increase in ulnar variance
of more than 2 mm, compared to the opposite side, is associated with a four-fold increase in the risk of scapholunate ligament injury.
The PA, which is shot with the arm abducted to 90[degrees] and the forearm in neutral rotation, is the best view to measure ulnar variance
. In addition, a pronated grip PA can show increased ulnar variance
, which may impact treatment decisions.