Variation of the Ulnar Variance with Powerful Grip

Causal relationships between ulnar variance and wrist disorders are known. Gripping and pronation cause proximal translation of the radius with respect to the ulna, leading to a statistically significant increase in ulnar variance. The purpose of this study was to investigate variation of the ulnar variance with powerful grip. A total of 41 male volunteers aged between 19 and 25 years (mean, 21.2+/-1.7 years) were studied. Posteroanterior X-ray films of all wrists were taken in the standardized position. After neutral posteroanterior X-ray films had been taken, subjects were asked to grip a Takei hand dynamometer with maximum force while repeated standardized posteroanterior X-ray films were obtained. Ulnar variance values were measured using the perpendicular method. Mean maximum grip force was 38.1 kg (range, 26.6-47.9 kg). Mean values of force-free (neutral) and forced ulnar variances were 0.06+/-0.21 mm and 1.87+/-0.23 mm, respectively. The difference in ulnar variance between the two groups was statistically significant ( P<0.001). The increase in ulnar variance with grip observed varied between 0.00 mm (minimum) and 3.97 mm (maximum), with a mean of 1.81 mm. Gaining an understanding of normal limits of ulnar variance modification with grip may be helpful in planning surgical treatment.