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Initial Symptoms

The patient reported:

• Deep, aching pain on the ulnar side of the wrist

• Increased pain while gripping objects, typing, and lifting weights

• Occasional clicking sensation in the wrist

• Reduced wrist strength and limited range of motion

Pain had been present for 6–8 months and was not relieved by rest or over-the-counter painkillers.

Clinical Examination

On physical examination:

• Tenderness over the ulnar wrist region

• Pain aggravated by wrist deviation toward the little finger

• Mild swelling without visible deformity

Based on symptoms and examination, Ulnar Impaction Syndrome was suspected.

Diagnostic Evaluation

To confirm the diagnosis, the following investigations were performed:

• X-ray of the wrist: Showed positive ulnar variance, where the ulna was longer than the radius

• MRI scan: Revealed degeneration of the triangular fibrocartilage complex (TFCC) and increased stress between the ulna and carpal bones

Diagnosis

Ulnar Impaction Syndrome causing chronic ulnar-sided wrist pain

Treatment Approach

Non-Surgical Management (Initial Phase)

The patient first underwent conservative treatment:

• Wrist immobilization using a brace

• Anti-inflammatory medications

• Activity modification

• Physiotherapy

After 8 weeks, symptoms improved slightly but pain persisted during daily activities.

Surgical Treatment

Due to ongoing pain, surgical intervention was recommended.

• Procedure: Ulnar Shortening Osteotomy

• Goal: Reduce pressure between the ulna and wrist bones

• Surgery Type: Minimally invasive, internal fixation with plate and screws

Post-Surgery Recovery

• Wrist immobilization for 4 weeks

• Gradual physiotherapy and range-of-motion exercises

• Strength training started after 8 weeks

Outcome & Results

• Significant pain relief within 6 weeks

• Full return to desk work in 2 months

• Complete recovery and normal wrist function by 4–5 months

• No recurrence of pain at 1-year follow-up

Patient Experience

“I had wrist pain for months and thought it was just a strain. After proper diagnosis and treatment, I’m now completely pain-free and back to normal life.”

Key Takeaways

• Persistent pain on the little finger side of the wrist should not be ignored

• Early diagnosis of Ulnar Impaction Syndrome prevents long-term joint damage

• Both non-surgical and surgical treatments can be effective depending on severity

• Surgery offers excellent outcomes when conservative treatment fails