Positive & Negative Ulnar Variance Treatment

Read about Positive & Negative Ulnar Variance Treatment.

Ulnar variance is a term used to describe the relationship between the radius and ulna bones in the forearm. It refers to the difference in length between these two bones and can have significant implications for the wrist and hand.

The forearm is composed of two bones, the radius, and the ulna. These bones play a crucial role in the movement and stability of the wrist and hand. Ulnar variance refers to the difference in length between the ulna and radius bones. Positive ulnar variance occurs when the ulna is longer than the radius, while negative ulnar variance occurs when the ulna is shorter.

Understanding Ulnar Variance

Ulnar variance has a direct impact on the distribution of forces in the wrist joint. When there is a significant difference in length between the ulna and radius, it can lead to an imbalance and uneven load distribution. This imbalance can cause wrist pain, limited range of motion, and other complications.

What is Positive Ulnar Variance?

Positive ulnar variance is characterized by the ulna being longer than the radius. This condition can increase the load-bearing on the ulnar side of the wrist, leading to various issues. Over time, positive ulnar variance can result in wrist pain, cartilage wear, and the development of conditions such as ulnar impaction syndrome.

What is Negative Ulnar Variance?

Negative ulnar variance, on the other hand, occurs when the ulna is shorter than the radius. This condition can cause excessive loading on the radial side of the wrist, leading to conditions like Kienböck's disease. Individuals with negative ulnar variance may experience pain, stiffness, and limited mobility in the wrist joint.

Ulnar Variance Causes

Ulnar variance can be influenced by various factors. One common cause is the natural variation in bone length among individuals. However, certain conditions and injuries can also contribute to ulnar variance. These include growth plate injuries, fractures, and degenerative diseases such as osteoarthritis.

Ulnar Variance Symptoms 

The symptoms of ulnar variance can vary depending on whether it is positive or negative. Common symptoms include wrist pain, swelling, tenderness, limited range of motion, and difficulty gripping objects. A thorough physical examination, medical history review, and imaging tests such as X-rays or MRI scans are typically used to diagnose ulnar variance.

Treatment Options

The treatment approach for ulnar variance depends on the severity of the condition, the presence of symptoms, and individual factors. Both non-surgical and surgical options are available to address ulnar variance and its associated complications.

Non-Surgical Treatments

Non-surgical treatments are often recommended initially to manage ulnar variance. These may include:

Medications: 

Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and reduce inflammation.

Immobilization: 

Wearing a splint or cast can provide support and promote healing.

Physical therapy: 

Specific exercises can improve wrist strength, flexibility, and range of motion.

Assistive devices: 

The use of braces or orthotics may provide additional support and alleviate symptoms.

Surgical Treatments

Surgery may be necessary for more severe cases of ulnar variance or when non-surgical treatments fail to provide adequate relief. The surgical options include:

Ulnar shortening osteotomy

This procedure involves removing a small section of the ulna bone to achieve a better balance between the ulna and radius.

Ulnar lengthening: 

In rare cases of negative ulnar variance, bone grafting or distraction osteogenesis techniques may be employed to lengthen the ulna.

Joint realignment: 

Surgical procedures such as arthroscopy or joint fusion may be performed to address underlying joint problems associated with ulnar variance.