The ulnar notch (sigmoid notch) of the radius is the concave medial articular surface of the distal radius that accommodates the ulnar head at the distal radioulnar joint (DRUJ). It is lined with hyaline cartilage and allows the radius to rotate around the ulna during forearm pronation and supination.
The sigmoid notch shape (flat, intermediate, or C-type) influences DRUJ stability, with flatter notches predisposing to instability. DRUJ arthrosis from sigmoid notch injury produces ulnar-sided wrist pain with rotation. Darrach resection removes the ulnar head from this articulation; ulnar head replacement or sigmoid notch reconstruction preserves the DRUJ. The notch dimensions are measured on CT for DRUJ arthroplasty sizing.
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