No abstract

The diagnosis of ulnar impingement is often missed because of a low index of clinical suspicion. Furthermore there has been no investigation that will demonstrate it. Most commonly impingement is seen as a complication of surgical procedures involving resection of all or part of the distal ulna, with or without resection or arthrodesis of the distal radioulnar joint. We demonstrate a simple radiological investigation that clearly confirms the diagnosis.

The distal radio-ulnar ligaments (DRUL) are key components of the triangular fibrocartilage complex (TFCC). The dorsal DRUL tightens during pronation of the forearm and helps to stabilize this motion. 12 women and three men at our clinic have been treated for DRUJ instability secondary to dorsal DRUL rupture or attenuation. Their chief complaint was pain. The dorsal DRUL was reconstructed using a tendon graft, the ends of which were anchored in the bone of the radius and ulna. This technique has been shown to correct dynamic DRUJ instability in carefully selected patients, decreasing or eliminating pain and restoring normal function.