Although dynamic increases in ulnar variance may accompany functional activity, radiographic assessment of ulnar variance traditionally has used a neutral rotation x-ray of the wrist that provides an image of the radioulnar length with the wrist unloaded. Such a view may underestimate variance in wrists in which power grip and pronation result in significant proximal migration of the radius. This study investigates the effect of a maximum grip effort in combination with forearm pronation on ulnar variance in 22 patients who presented with ulnar wrist pain. The pronated grip x-ray view resulted in statistically significant increases in ulnar variance. Preoperative ulnar variance should be measured using both neutral rotation and pronated grip x-rays before selecting treatment for causes of ulnar wrist pain that are affected by radioulnar length so that dynamic increases in ulnar variance are considered when operative treatment is necessary. (J Hand Surg 2000;25A:352–357. Copyright © by the American Society for Surgery of the Hand.)
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Accepted: October 5, 1999
Received: February 27, 1998
*Reprint requests: Matthew M. Tomaino, MD, 3471 Fifth Ave, Suite 1010, Pittsburgh, PA 15213.
**No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
**J Hand Surg 2000;25A;352–357.
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.