Negative ulnar variance
Negative ulnar variance describes a state where the ulna is abnormally shortened 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.
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Anatomy: Upper limb
-
skeleton of the upper limb
- clavicle
- scapula
- humerus
- radius
- ulna
- carpal bones (mnemonic)
- metacarpals
- phalanges
- accessory ossicles of the upper limb
- accessory ossicles of the shoulder
- accessory ossicles of the elbow
-
accessory ossicles of the wrist (mnemonic)
- os centrale carpi
- os epilunate
- os styloideum
- os hamuli proprium
- lunula
- os triangulare
- trapezium secondarium
- os paratrapezium
- os radiostyloideum (persistent radial styloid)
- joints of the upper limb
-
pectoral girdle
-
shoulder joint
- articulations
- associated structures
- joint capsule
- bursae
- ligaments
-
movements
- scapulothoracic joint
- glenohumeral joint
- arm flexion
- arm extension
- arm abduction
- arm adduction
- arm internal rotation (medial rotation)
- arm external rotation (lateral rotation)
- circumduction
- blood supply - scapular anastomosis
- ossification centers
-
shoulder joint
-
elbow joint
- proximal radioulnar joint
- ligaments
- associated structures
- movements
- alignment
- blood supply - elbow anastomosis
- development
-
wrist joint
- articulations
-
ligaments
- intrinsic ligaments
- extrinsic ligaments
- radioscaphoid ligament
- dorsal intercarpal ligament
- dorsal radiotriquetral ligament
- dorsal radioulnar ligament
- volar radioulnar ligament
- radioscaphocapitate ligament
- long radiolunate ligament
- Vickers ligament
- short radiolunate ligament
- ulnolunate ligament
- ulnotriquetral ligament
- ulnocapitate ligament
- ulnar collateral ligament
- associated structures
- extensor retinaculum
- flexor retinaculum
- joint capsule
- movements
- alignment
- ossification centers
-
hand joints
- articulations
- carpometacarpal joint
-
metacarpophalangeal joints
- palmar ligament (plate)
- collateral ligament
-
interphalangeal joints
- palmar ligament (plate)
- collateral ligament
- movements
- ossification centers
- articulations
-
pectoral girdle
- spaces of the upper limb
- muscles of the upper limb
- shoulder girdle
- anterior compartment of the arm
- posterior compartment of the arm
- anterior compartment of the forearm
-
posterior compartment of the forearm (extensors)
- superficial
- deep
- hand (mnemonic)
- accessory muscles
- blood supply to the upper limb
-
arteries
- subclavian artery (mnemonic)
- axillary artery
- brachial artery (proximal portion)
- ulnar artery
- radial artery
- veins
-
arteries
- innervation of the upper limb
- intercostobrachial nerve
-
brachial plexus (mnemonic)
- branches from the roots
- branches from the trunks
- branches from the cords
- lateral cord
- posterior cord
- medial cord
- terminal branches
- lymphatic drainage of the upper limb
Wrist pathology
- alignment
- wrist fractures and dislocations
- distal radial fracture
- pediatric
- carpal bones
- carpal instability
- osteonecrosis
- triangular fibrocartilaginous complex (TFCC) injuries
- ulnar-sided wrist impaction and impingement syndromes
- soft tissue and tendons
- arthritides
