What is Ulnar Styloid Impaction Syndrome?

Our wrists are complex, and feature numerous delicate bones that are vital to so many of our daily rituals and tasks. If pain suddenly strikes the wrist, it can become unbearable, and may significantly hinder one's quality of life if action is not taken quickly.

There are many conditions and ailments that can impact on the wrist's ability to perform, and with such conditions as ulnar styloid impaction syndrome it can be hard to ignore the gross discomfort and searing pain. Should the condition strike, it is understandable that you will want to tackle the pain as quickly as possible. To help you identify the best treatments for your condition, read on to learn all about what exactly ulnar styloid impaction syndrome is, how to recognise the symptoms, and what treatments may be an option for you.

What Is the Styloid?

Before getting to grips with ulnar styloid impaction syndrome, it will be useful to locate the associated bones in the forearm so you can identify the source of the pain. The forearm comprises two bones: the radius and the ulna. The ulna is the bone on the outer, or little pinky finger, side of the arm.

At the end of the ulna, there is the styloid process, often referred to simply as the styloid. This styloid process of the ulna protects towards the wrist, with the rounder end of the bone attaching the ulna to the ulnar collateral ligament of the wrist.

What Is Ulnar Styloid Impaction Syndrome?

When the styloid is too long, which is typically agreed to be when the styloid is greater than 6mm, it presses against the wrist bones, with pressure particularly targeted towards the triquertrum bone. This pressure can cause inflammation and swelling, and may also result in oedema and bruising of the bone.

When this pressure from the tip of the styloid occurs, it can damage the triangular fibrocartilage complex (TFCC) ligament, and this can tear, thus exposing the bones to friction. This impact from the styloid creates the condition typically referred to as ulnar styloid impaction syndrome, wherein pain, instability, and breakdown of bone can occur.

Do I Have Ulnar Styloid Impaction Syndrome?

While diagnosis should always be sought from a medical professional, the list of symptoms below can be associated with ulnar styloid impaction syndrome. While these symptoms can also manifest as a result of other conditions and wrist complications, they may help you to identify ulnar styloid impaction syndrome.

• Ulnar-sided wrist pain: One of the first symptoms you may notice is a discomfort or pain on the ulnar (outer) side of the wrist. This may be mild to begin with, and can increase in intensity over time. Possible causes for this pain is bone bruising and bone oedema.
• Synovitis/inflammation: Due to the friction between the bones, synovitis can occur. This is the inflammation of the synovial lining of the joint, which can result in swelling and tenderness.
• General tenderness: The area surrounding the bony bump, or ball, on the ulnar side of the wrist can become painful and tender to the touch. It may also feel hot as a result of the inflammation, and may appear swollen.

How Do I Treat Ulnar Styloid Impaction Syndrome?

Once you have received your diagnosis, you can begin to consider the various treatment options for ulnar styloid impaction syndrome. Some treatments are more invasive than others, and, depending on the severity of the condition, you may find that some may be more suitable, or even necessary.

Surgical Procedures

In extreme cases of ulnar styloid impaction syndrome, surgery may be essential. There are two main types of surgical procedure for treating the condition: decompression and stylectomy. With decompression, the styloid process is shaved down to shorten in, thus preventing it from aggravating the wrist bones. However, it may be necessary to completely remove the styloid, and this is done in a procedure known as a stylectomy.

Prescribed Anti-Inflammatories

Both for earlier stages of ulnar styloid impaction syndrome and for easing the condition while awaiting surgery, your doctor may prescribe anti-inflammatories. This medication will help to reduce the inflammation, which in turn will reduce the pain and swelling, helping you to better manage the syndrome while you await further treatment.

Hand Therapy

Both before and after surgery, it will be particularly useful to undergo a course of hand therapy. This will encourage correct movement of the wrist to prevent from overflexion or overextension. While this will be paramount for ensuring an effective recovery during post-operative rehabilitation, it can also reduce pain and discomfort by ensuring that the wrist does not move unnaturally.

Wrist Supports and Braces

Similar to hand therapy, utilising the benefits of a suitable wrist support or wrist brace can be worn both before and after surgery. If worn beforehand, certain supports can stabilise the wrist, preventing it from bending awkwardly and causing more damage. If you wear a wrist brace that provides gentle compression following surgery, it can encourage a quickened rate of healing to help you on the mend. Some braces and supports can also completely immobilise the wrist to prevent it from becoming subject to further injury, helping to ensure that you can find the perfect wrist support for the needs of your condition.

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