β£What is it?Excessive impact between ulna and lunateβ£What is the normal loading mechanics at ulnar?Normal loading is 80% radius, 20% ulna+2mm Ulnar variance positive β 60% radius, 40% ulnaβ£Causes of ulnar abutment syndrome?Radial shortening from #, TFCC degenerative tearβ£What clinical tests?β£Nakamura stress test aka Ulnocarpal stress testThe difference between this and TFCC compression test is the pronation supination component. While TFCC compression test is a Radial-ulnar deviation movement.nakamura1997.pdf1894.2KBβ£Management of Chronic, Degenerative TFCC/ Ulnar Abutment Syndrome?"Offloading procedures"< 2mm ulnar positive = Wafer procedure> 2mm ulnar positive = ulnar shortening osteotomiesSalvage Procedures - if OA changes and painDarrach, Sauve-kapandji, Bowerβs hemiresectionβ£Resection of distal ulna - Darrach'sβ£Arthrodesis of DRUJ with proximal pseudoarthrosis- Suave Kapanji technique