In the wrist of patients with ulnar dysplasia, a spectrum of features may be exhibited. Usually, there is ulnar angulation. It is not as severe as the converse deformity in radial dysplasia. It may be caused by a fibrocartilaginous anlage which is a remnant of the distal ulna and has no growth potential. It attaches to the ulnar carpus or distal radius and may act as a tether to cause bowing. Ulnar angulation may be also contributed to by bowing of the radius and the slant of the distal articular surface.
The carpal bones are abnormal in a minority of patients. They may be absent, synostosed or malformed. The pisiform bone is the one that is most frequently absent.
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