Negative ulnar variance

Last revised by Daniel J Bell on 14 Oct 2022

Negative ulnar variance describes a state where the ulna is abnormally shortened (by more than 2.5 mm) compared to the radius and plays an important role in wrist pathology.

There is a significant association between negative ulnar variance and Kienböck disease, although the majority of people with negative ulnar variance do not have this condition. A causal association is difficult to prove, however the effectiveness of decompressive procedures such as radial shortening or ulnar lengthening in relieving pain and preventing further collapse of the lunate supports this 1.

Ulnar impingement syndrome, a wrist condition caused by a shortened distal ulna impinging on the distal radius proximal to the sigmoid notch of radius, is usually due to acquired ulnar shortening but can be due to de novo negative ulnar variance 2.

See also

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Cases and figures

  • Figure 1: negative ulnar variance
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  • Case 1
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  • Case 2
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  • Case 3: Kienbock disease
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  • Case 4: ulnar impingement
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  • Case 5
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  • Case 6: with Kienböck disease
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