The ulnar head is the expanded distal end of the ulna, articulating with the sigmoid notch of the radius at the distal radioulnar joint and with the triangular fibrocartilage complex superiorly. Its rounded articular surface allows forearm pronation and supination. The ulnar styloid projects posteromedially from the head.
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| Ossification | The distal ulnar physis is the last to fuse in the upper limb, typically closing at 16-17 years in females and 18-19 years in males. |
The ulnar head is commonly prominent after distal radius fractures that heal with radial shortening, producing an impingement syndrome at the DRUJ. Distal ulna resection (Darrach procedure) or ulnar head replacement is used for DRUJ arthritis and post-traumatic deformity. The fovea at the base of the ulnar styloid is the critical attachment of the TFCC deep fibres.
Turn the forearm palm down and look at the back of the wrist on the little-finger side; the rounded bump is the head of the ulna. It is most prominent in pronation and becomes less obvious when the palm is turned up.
Tearing of the triangular fibrocartilage complex, often with a distal radius fracture, lets the ulnar head sublux dorsally, causing ulnar-sided wrist pain and clicking on rotation.
A relatively long ulna (positive ulnar variance) loads the ulnar head against the TFCC and lunate, causing ulnar wrist pain and cartilage wear.
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