Failed ulnar head resection: prevention and treatment

Distal ulnar head resections may cause a painful impingement of the distal ulnar stump against the radius during loaded forearm rotation. Different soft-tissue procedures have been suggested to solve this difficult problem, but none has demonstrated clear superiority over the others. The introduction of a variety of ulnar head and total radio-ulnar joint prostheses has provided a new method of addressing this problem, but there is presently no evidence that these implants produce long-lasting results. This paper critically reviews these different options, and emphasizes techniques which may help to minimize the risk of complications when excision of the ulnar head is unavoidable.