[The caput-ulnae-syndrome. Pathogenesis, clinic and therapy]

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Hand Surgery

Background:

• The ulnar head is vital for wrist stability.
• Caput ulnae syndrome and rheumatoid arthritis significantly impact wrist function.
• The triangular fibrocartilage complex (TFCC) integrity is critical in rheumatoid wrists.

Purpose of the Study:

• To outline surgical indications and methods for treating caput ulnae syndrome and rheumatoid wrist involvement.
• To emphasize the importance of considering the radiocarpal joint and distal radioulnar joint (DRUJ) in surgical planning.

Main Methods:

• Review of surgical treatments for caput ulnae syndrome and rheumatoid wrist.
• Discussion of early synovectomy (open or arthroscopic) for synovitis.
• Description of ulnar head resection with dorsal wrist stabilization for advanced cases.
• Mention of DRUJ arthrodesis or arthroplasty as alternative treatments.

Main Results:

• Early surgical treatment is indicated for drug-resistant synovitis and monarthritis.
• Ulnar head resection with dorsal stabilization is often necessary for manifest caput ulnae syndrome, including extensor tendon rupture.
• The DRUJ typically requires treatment concurrent with the radiocarpal joint.

Conclusions:

• The ulnar head's role in wrist stabilization necessitates its consideration in caput ulnae syndrome treatment.
• Early surgical intervention, including synovectomy or ulnar head resection, improves outcomes for rheumatoid wrists.
• Treatment choice depends on the specific wrist changes, with combined radiocarpal and DRUJ management being most common.