Adam Rufa - 10/5/2006

Question
My wife has a condition called Positive Ulnar Variation. She has had a cortizone shot in the wrist and so far thats it. We are wondering what some of the treatments are for the condition?

Answer
A positive ulnar variance is a structural abnormality and not necessarily a source of dysfunction. It can lead to excessive stress on the joints and soft tissue of the wrist and that can produce pain.

If you hold your hand with the palm up the thumb side of the forearm is the radius bone and the pinky side of the forearm is the ulna. Normally the radius is longer than the ulna so if you look at your wrist the thumb side of your wrist is longer and naturally causes a slight tip in your hand away from the radius.

In some people the ulna is longer than the radius and this is called and positive ulnar variance. This can be genetic but is often associated with early trauma on the radius which causes the growth plate to close too soon (which stops the growth of the radius). This often occurs in gymnasts from repetitive hard landings on the hands.

Often treatment is aimed at the symptoms that are caused by the variance. Cortisone injections into painful joints or tendons can help. Sometimes physical therapy can help. However, the only way to correct the variance is to surgically shorten the ulna. I guess the radius could be surgically lengthened but I am not sure if that procedure is done.

Hope this helps some.

Adam