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Ulnar-Sided Wrist Pain at Ulnar Impaction

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Pain on the little-finger side of the wrist from the ulna grinding against the wrist bones, and how shortening it relieves the pressure.

Anatomiya ng triangular fibrocartilage complex (TFCC) sa gilid ng pulso kung saan matatagpuan ang maliit na daliri.
Ang TFCC at ang ulnar (kaliwang daliri) na bahagi ng pulso — isang karaniwang sanhi ng sakit sa pulso sa gilid ng ulna. Elatmani s / Wikimedia Commons, CC BY-SA 3.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Ang sakit sa gilid ng pulso na nasa kaliwang daliri (ang ulnar na bahagi) ay napakadalas, at mayroon itong ilang posibleng sanhi. Ang pahinang ito ay tungkol sa pinakamahalagang mekanikal na sanhi: isang kondisyon na tinatawag na ulnar impaction (kilala rin bilang ulnocarpal abutment).

Ang sakit ay karaniwang nasa malalim na bahagi sa labas na gilid ng pulso, patungo sa likod ng kamay. Madalas itong lumala kapag mahigpit kang humawak, ikaw ay nag-iikot ng iyong braso, o yumuyuko ang pulso patungo sa kaliwang daliri, kaya ang mga pang-araw-araw na gawain tulad ng pagbukas ng bote, pag-ikot ng susi, paggamit ng screwdriver, pagpiga ng tela, o pagtindig sa kamay upang tumayo mula sa upuan ay maaaring magdulot nito. Maraming tao rin ang nakakaramdam ng klik o kunkot sa pulso sa ilang mga galaw, at ang pulso ay maaaring masaktan pagkatapos ng isang araw ng mabigat na paggamit. Ang paglalagay ng bigat sa pulso (sa isang plank, push-up, o pagtulak ng mabigat na pinto) ay isang karaniwang nagpapalala.

Karaniwan itong unti-unting lumala imbes na magsimula sa isang iisang sugat, bagama't maaari itong sumunod sa isang fracture ng pulso.

Ano ang nangyayari talaga

Dalawang buto ng braso ang tumataas patungo sa pulso: ang radius (panig ng hinlalaki) at ang ulna (panig ng maliit na daliri). Upang mabuti ang paggalaw ng pulso, dapat nasa humigit-kumulang parehong antas ang mga dulo ng dalawang butong ito. Sa ulnar impaction, ang ulna ay medyo higit na mahaba kumpara sa radius, isang kondisyon na tinatawag ng mga doktor na positibong ulnar variance.

May mga taong kapanganakan na may medyo mahabang ulna. Sa iba, ito ay lumalabas pagkatapos: kadalasan kapag ang isang basag na pulso ay gumaling nang medyo maikli, na nag-iiwan ng radius na bahagyang mas maikli kaysa dati at ang ulna na parang lumalabas.

Anuman ang dahilan, ang kaunting karagdagang haba ay nangangahulugang ang dulo ng ulna ay dumudurog sa maliliit na buto ng pulso na nasa tabi nito (ang lunate at ang triquetrum) bawat beses na magpapabigat sa pulso. Sa pagitan ng mga butong ito ay may balat ng kartilago na tinatawag na TFCC (triangular fibrocartilage complex), na nagsisilbing shock-absorber. Ang paulit-ulit na pagdudurog ay dahan-dahang ginugugol ang balat na ito, maaaring masira ang TFCC, at sa paglipas ng panahon ay magdudulot ng pamamaga at kahit maliit na cyst sa buto sa ilalim. Ang proseso ng pagkasira na ito ang nagdudulot ng sakit, ang pag-click, at ang pagkawala ng kaginhawaan sa paghawak at pag-ikot. (May hiwalay kaming pahina tungkol sa TFCC injuries, na madalas na kasama ng kondisyong ito.)

Ano ang maaari naming gawin dito

Ang magandang balita ay ang karamihan sa mga tao ay nakakapagpagaling sa pamamagitan ng non-operative na paggamot, at doon naman tayo laging nagsisimula.

Pagpapahinahon nito. Ang mga unang hakbang ay simple: baguhin ang mga gawain na nagpapabigat sa ulnar na bahagi ng pulso (lalo na ang mabigat na pagkapit, pag-ikot, at pagdudulot ng bigat) sa loob ng ilang panahon, magsuot ng wrist splint upang pahintulutan ang joint na magpahinga, at gumamit ng anti-inflammatory na gamot upang mapababa ang sakit at pamamaga. Minsan, tumutulong ang steroid injection sa loob ng joint upang putulin ang siklo ng pamamaga.

Pagpapatunay sa diagnosis. Kasabay ng paggamot, karaniwan kaming kukuha ng X-rays upang sukatin nang eksakto kung paano magkakaayos ang dalawang buto (minsan gamit ang espesyal na "grip" view na nagpapakita nang higitan ang impakto), at madalas ay isang MRI upang tingnan ang cartilage, ang TFCC, at ang buto sa ilalim nito. Sa ilang okasyon, ginagamit ang keyhole na panonood sa loob ng joint (arthroscopy) upang kumpirmihin kung ano ang nangyayari at gamutin ito sa parehong oras.

Kung ito ay mananatili. Kapag ang mahusay na non-operative na paggamot ay hindi nakapagpahinga sa mga bagay, ang layunin ng operasyon ay alisin ang presyon sa ulnar na bahagi ng pulso. Ang pinaka-katatag na opsyon ay isang ulnar-shortening osteotomy, kung saan tinatanggal ng surgeon ang maliit na piraso ng ulna upang ibalik ito sa tamang haba at hahawakan ito ng maliit na plate habang ito ay gumagaling. Isang mas hindi invasive na alternatibo sa mga piniling kaso ay ang arthroscopic na "wafer" procedure, na nagpuputol ng maliit na halaga sa dulo ng ulna sa pamamagitan ng keyhole surgery. Parehong gumagana ang dalawa sa pamamagitan ng pagpigil sa buto na magkuskos laban sa pulso.

Ano ang inaasahan

Para sa karamihan ng mga tao, ang ulnar impaction ay isang problema na kayang kontrolin. Ang mga hindi operasyonal na pamamaraan ay nakakapag-ayos ng malaking bahagi ng mga kaso, at ang mga sintomas ay nagbabawas nang ang kasukasuan ay hindi na paulit-ulit na sobrang bigat.

Kapag kailangan ng operasyon, ang pagpapaliliit ng ulna ay isang maaasahang operasyon, at mga pag-aaral na sumunod sa mga pasyente sa loob ng maraming taon ay nag-ulat ng magandang, pangmatagalang pagpapagaan ng sakit at mataas na kasiyahan. Kailangan ng buto ng oras upang gumaling, kaya may panahon ng paggaling na ilang linggo sa isang splint o cast habang ang osteotomy ay nag-uugnay, sinundan ng unti-unting pagbabalik sa paghawak at pagdadala ng bigat. Ang mga pangunahing bagay na dapat tandaan ay ang buto ay minsan ay tumatagal nang higit pa sa inaasahan upang mag-ugnay, at ang maliit na plate ay minsan ay nararamdaman sa ilalim ng balat at minsan ay tinatanggal kapag lahat ay gumaling na. Sa kabuuan, ang karamihan ng mga tao ay bumabalik sa kanilang pang-araw-araw na gawain na may nawalang sakit.

Kailan kumonsulta sa doktor

  • Sakit sa pulso sa gilid ng ulna na hindi nawawala sa loob ng ilang linggo, o paulit-ulit na lumalabas kapag humahawak at pag-ikot, at dapat suriin.
  • Sakit na sumusunod sa nakaraang fracture ng pulso, lalo na kung hindi pa rin ganap na normal ang pakiramdam ng pulso mula noon.
  • Patuloy na click, clunk, o pagkakadikit sa gilid ng pulso kung saan matatagpuan ang maliit na daliri, lalo na kapag may bigat na nakadikit.
  • Sakit na nakakaapekto sa iyong trabaho o pang-araw-araw na gawain. Ito ang punto kung saan dapat suriin kung ano ang dahilan nito at ano ang maaaring gawin.

Reviewed by Dr Kieran Hirpara · 24 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

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