Ulno-carpal impaction syndrome is often secondary to the sequels of a fracture of the distal radius.
The inversion of the distal radio-ulnar index with a positive ulnar variance by shortening relative to the radius eventually leads to an abutment between the head of the ulna and the proximal articular face of the lunate. This contact leads to the alteration of the cartilaginous carpal surfaces. There are numerous treatments for the distal radio-ulnar component of malunion of distal radius fracture and the choice of therapy is based on specific evaluation of this joint through a clinical and radiological analysis.
Arthroscopy remains the best diagnostic element in evaluating the seriousness of the ulno-carpal abutment with a direct visualization of the cartilaginous lesions and allowing a precise assessment of the associated lesions, in particular on TFCC or LT ligament. When the inversion of the distal radio-ulnar index is less than or equal to 5mm, the surgical treatment can also be carried out by arthroscopy.