Abstract
Background Open or arthroscopic partial resection of the elongated ulnar styloid is the surgical
treatment of choice for ulnar styloid impaction syndrome.
Case Description A patient with a severely elongated processus styloideus ulnae (PSU) with a chronic
impaction of the distal-radial margin against the triquetrum suffered a traumatic
triangular fibrocartilage complex (TFCC) Palmer 1B rupture and DRUJ instability. The
length of the PSU was 9 mm. After failed conservative treatment, a partial oblique
arthroscopic resection of the PSU and simultaneous TFCC reinsertion were performed
with uneventful recovery.
Literature Review Arthroscopic resection has emerged as an alternative to the traditional open PSU
resection for the treatment of styloid impaction syndrome. A transverse resection
is described as the treatment of choice. Regarding the extent of resection subtotal
ligament sparing resection or resection to the lower margin have been suggested.
Clinical Relevance Surgical planning of PSU resection should take into consideration the anatomy of
the impingement. The extent of resection should be planned individually, and sometimes
an oblique resection may be the preferred option.
Keywords
ulnocarpal abutment - ulnar styloid impaction - wrist arthroscopy - osteotomy - wafer
