Ulnar Variance in Athletes: A Scoping Review.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Radiology

Background:

• Ulnar variance (UV) describes the relative lengths of the radius and ulna.
• Perturbed UV, particularly positive UV, is observed in athletes and can lead to wrist pathologies.
• These conditions may necessitate conservative or surgical treatment, potentially impacting sports participation.

Purpose of the Study:

• To systematically review diagnostic imaging methods for UV in athletes.
• To explore the association between UV and specific wrist conditions.
• To present treatment strategies for symptomatic UV in athletic populations.

Main Methods:

• A comprehensive scoping review was conducted using PRISMA-ScR guidelines.
• Systematic searches were performed in PubMed, CINAHL, Embase, and SPORTDiscus up to February 2, 2022.
• Included studies focused on UV characterization, imaging modalities, and athletic populations.

Main Results:

• Twenty-two studies met the inclusion criteria, analyzing data from eight sports.
• Conventional radiography is the primary diagnostic method for UV, with various radiographic views and measurement techniques employed (Hafner's, Palmer's, perpendiculars).
• Athletes exhibited higher rates of positive UV compared to non-athletes, and positive UV was associated with triangular fibrocartilage complex tears, focal lunate necrosis, and ulnar abutment.

Conclusions:

• Conventional radiography is the established gold standard for diagnosing UV in athletes.
• Hafner's method is the most frequently utilized technique for measuring UV on radiographs.
• Positive UV in athletes may signal underlying wrist pathology requiring surgical intervention.