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Related Concept Videos

Bones of the Upper Limb: Ulna01:15

Bones of the Upper Limb: Ulna

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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...
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Reverse Wafer Procedure for Ulnar Impaction Syndrome.

Ismail Bulent Ozcelik1, Mohd Hanifah Jusoh2, Ali Cavit3

  • 1Hand and Upper Extremity Surgery Unit, Yeniyuzyil University, Gaziosmanpasa Hospital, El Istanbul Hand and Microsurgery Group, Nişantaşi University School of Health Sciences.

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Summary

A new "reverse wafer procedure" offers a surgical solution for ulnar impaction syndrome. This technique decompresses the ulnocarpal joint by resecting the lunate, avoiding common complications of existing methods.

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Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Biomechanics

Background:

  • Ulnar impaction syndrome involves excessive load on the ulnocarpal joint, causing damage to the ulnar head and lunate.
  • Current surgical treatments like ulnar shortening osteotomy and the standard wafer procedure have limitations.
  • These limitations include potential iatrogenic injury and technical challenges in arthroscopic approaches.

Purpose of the Study:

  • To introduce and describe a novel surgical technique, the "reverse wafer procedure," for treating ulnar impaction syndrome.
  • To present an alternative method for decompressing the ulnocarpal joint load.
  • To highlight the advantages of this new technique over existing surgical options.

Main Methods:

  • The study details a surgical technique involving resection of the proximal ulnar side of the lunate.
  • This differs from the standard wafer procedure, which involves partial resection of the distal ulnar head.
  • The procedure aims to decompress the ulnocarpal joint load.

Main Results:

  • The reverse wafer procedure avoids iatrogenic central tears of the triangular fibrocartilage.
  • It eliminates the need for technically demanding distal radioulnar joint portal arthroscopy.
  • The technique preserves the integrity of the distal radioulnar joint.

Conclusions:

  • The reverse wafer procedure is a viable novel technique for managing ulnar impaction syndrome.
  • This method offers potential advantages by mitigating risks associated with standard procedures.
  • Further research may validate its efficacy and long-term outcomes in decompressing ulnocarpal joint load.