Ulnar Impaction Syndrome

[valanhb]

I went to see an orthopedic specialist on Thursday about the wrist pain I've been having. Good news is that it's not Carpal Tunnel. Bad news is that it's mechanical.

Here's my visual aid.

She didn't give a name to it, but if anyone knows it would be great so I can research it a little more. Basically, it's a hereditary bone thing. The Ulna (lone, pinkie side arm bone, which has the protruding part on the wrist) is too long, and over the years has hammered away at the piece of cartilage separating the ulna from the wrist bones. She said at this point she thinks that the cartilage has torn in the thinnest part (the middle), which is causing the bones to come into direct contact and thus the sometimes excruciating pain and swelling.

Has anyone here had experience with this? What did you do that helped? Did you have the surgery to fix it (the option she prefers is to actually take a slice of the ulna out instead of just shaving off the tip of the protruding bone)? Did it fix it?

She is sending me to physical therapy for a nerve issue I'm also having on the same arm, and hopes they might be able to help with something that will help with this issue. I'm also on Celebrex to try to keep the pain and swelling under control.

 

[pookie-poo]

I believe it is called "Ulnar Impaction Syndrome". The treatment of choice is surgery to shorten the ulna, called 'ulnar osteotomy'. I've worked in surgery for over 25 years and only seen it done a couple of times (usually due to improper healing of an ulnar fracture.) I hope these two medical terms will help you research the syndrome and treatments, so you can become familiar with it and discuss your treatment options with your doctor. Good luck!

 

[valanhb]

Oh thank you! The doctor was wonderful in that she explained everything in human terms, not just doctor terms, but it's hard to research without the real terms.

 

[valanhb]

Wow, I did some research on it and every symptom matches up to me, including the x-ray images. Looks like she knows what she's doing.

I also did some research on the surgery, and even found pictures of it. Yeah, it's kinda scary. The thing I can't find information on is the recovery time. I found one document that is obviously what an orthopedic surgeon gives his patients, but it wasn't entirely clear.

Anyone had that surgery, whether for traumatic injury or degenerative injury (like mine)?

 

[pookie-poo]

Several years ago, my sister tripped over her dog and landed on her wrist on the cement patio. She broke the radius of her left arm. She underwent closed reduction in the E.R., but they were unable to get good approximation of the fracture. A couple of days later she had surgery...open reduction with bone graft and application of an external fixation device. I believe she was in the external fixator for about 8 weeks. I'm guessing here, but for a surgical osteotomy with internal fixation (plates and screws across the place where the bone was removed) you would probably be in a cast for about 6 weeks. Most fractures are pretty well healed by the 6 week mark. My sister was in physical therapy for about three months, 3 times a week, to maintain mobility in her hand and wrist joint. I honestly don't know how much PT you would require, but I imagine there would be some needed. I understand the surgical procedure completely, but unfortunately, post-op healing time, physical therapy, etc., is something that I never really get much exposure to.

 

[ldg]

Oh Heidi, I'm so sorry to hear about this! I don't know if you remember all that pain I had for several years in my wrist. Thank god mine was only a nerve problem. If you have to have surgery, I sure hope it works and heals quickly and properly.

As to the nerve problem, I started taking massive doses of B vitamins - particularly B6. It worked within a few weeks. I don't know if that will help the nerve problem you've been having, but I figured it couldn't hurt to share. I'd seen so many doctors and suffered pretty badly for 2 - 3 years - and one Doc's off-hand suggestion worked.

(((((((((((((((((((((((((((((((((((hugs))))))))))))))))))))))))))))))))))))))))

Laurie

 

[momofmany]

This may sound really weird, but I had a greyhound that had that problem. His ulna grew nearly an inch longer than his radius bone. He had the surgery where they broke the bones apart, cut off the end of the ulna and fused them back together. Tyler had a cast for about 6 months and follow up visits to the vet for a year. But do remember that this was done to a greyhound, used to running madly on his 4 legs. They kept the cast on to prevent movement in that wrist.

We did it to him when he was about 2 years old. He never had problems with it, although we were warned about arthritis as he aged. We lost him at 10 to bone cancer (unrelated) so we'll never be sure if there would have been late life issues.

girl. I'm assuming you've done the full gamut of anti-inflamatories to treat it?

 

[cherdul]

I had this surgery on 1/24/14.  I fell 5 years ago and tore my TFCC.  I had it repaired twice with little relief.  I went to a new doctor for a second opinion and was told I had ulnar impaction syndrome.  My ulnar was 2mm longer than the radial. (this is from birth, not from injury.  this made me prone to tearing my TFCC when I fell)  Knowing how much my TFCC surgery hurt I was prepared for the worst.  This surgery was not bad at all.  I had my TFCC repaired again as well as the lunate. I had 2mm removed from my ulnar and a plate w/ 7 screws.  I started PT 2 weeks ago.  I have regained about 60% of my pronation and supination so far.  I get an occasional ache at the incision site but nothing prolonged and nothing unbearable.  I feel much better after this surgery than I did at this point after the last 2 surgeries. 

I hope this helps!

 

[vsandalee]

Just found this site researching ulnar impaction syndrome. I was diagnosed this week after a panel of blood tests checking for autoimmune issues, MRI on my brain with and without contrast, one on my cervical spine and finally an MRI on my wrist revealed the issue. It's been a LONG 3 years trying to uncover the source of what seemed to be a nerve issue in my hand, causing numbness and tingling, swelling and pain in my hand, wrist, elbow and shoulder. I was also told I'd have to do the shortening surgery.

I stopped the PT for the C-5/6 bulge in my neck because it didn't really help. The nerve conduction study indicated that I don't have nerve damage... But the really interesting thing is that I had a cortisone shot in the wrist on Friday - today's Sunday, 2 days later - wrist is sore, numbness / tingling is gone in the rest of the arm.

I say this because it might make sense to focus on solving one problem at a time. If the wrist is giving you the most trouble, get a shot and see how the rest of the arm feels. If your bones in the wrist were as inflamed and cystic as mine were, you might be surprised by the relief you feel.

I won't do the surgery until Nov. My positive is 2.5mm too long. Did you have the surgery? What was it like? I'm freaked out.

 

[AbbysMom]

Just found this site researching ulnar impaction syndrome. I was diagnosed this week after a panel of blood tests checking for autoimmune issues, MRI on my brain with and without contrast, one on my cervical spine and finally an MRI on my wrist revealed the issue. It's been a LONG 3 years trying to uncover the source of what seemed to be a nerve issue in my hand, causing numbness and tingling, swelling and pain in my hand, wrist, elbow and shoulder. I was also told I'd have to do the shortening surgery.

I stopped the PT for the C-5/6 bulge in my neck because it didn't really help. The nerve conduction study indicated that I don't have nerve damage... But the really interesting thing is that I had a cortisone shot in the wrist on Friday - today's Sunday, 2 days later - wrist is sore, numbness / tingling is gone in the rest of the arm.

I say this because it might make sense to focus on solving one problem at a time. If the wrist is giving you the most trouble, get a shot and see how the rest of the arm feels. If your bones in the wrist were as inflamed and cystic as mine were, you might be surprised by the relief you feel.

I won't do the surgery until Nov. My positive is 2.5mm too long. Did you have the surgery? What was it like? I'm freaked out.

Hi an welcome to the site!

I'm so sorry you are having issues. This is a really old thread and the people you want answers from may not see your post. The best bet would probably be to send them a Private Message. Good luck!

 

[neesie]

I was diagnosed with Ulnar Impaction Syndrome.  I fractured both the radius & ulna just above the wrist in Feb 2013.  Repaired with plates & screws in both bones.  Now, the Surgeon recommends cutting a piece out of the ulna to alleviate the pain/lack of movement/tingling.  Any advice or thoughts from somebody who has had this done would be greatly appreciated!  I'm a veterinarian & cutting a piece of bone out, then applying more plates & screws to have it heal seems a little extreme & scary!