Ulnar impact syndrome refers to a condition in which the end of the ulna bone (the outer bone of your arm, palm-down) puts excessive pressure on one of the wrist bones, usually the lunate. This can cause pain when moving or flexing the wrist. Traditionally, open surgery was done to shorten the ulna bone and relieve this pressure. In cases where the needed bone reduction is less than three millimeters, however, the specialists at our Houston offices can achieve equal results more quickly, with shorter recovery time, through an arthroscopic procedure.
Arthroscopic treatment of ulnar impact syndrome (also known as the “wafer procedure”) begins with a very small incision in the upper side of the wrist. A narrow scope is threaded into the joint area to guide the surgeon’s eye.
A second scope, threaded into the area from another small incision, transports instruments for shaving and debriding (removing) tissues. Oftentimes, a torn triangular fibrocartilage complex (TFCC) is associated with ulnar impact syndrome. These tissues, which rest between the ulna and wrist bones, are first reshaped to provide a stable rim for optimal ulnar bone support. The end of the ulnar bone that is pressing on the wrist bones is then shaved down to where it can no longer abut the wrist directly, bone-on-bone.
This arthroscopic procedure takes 10 minutes and is done under twilight anesthesia. Scars are minimal and return to normal activities is quick, usually no more than three weeks.