of Peripheral Triangular Fibrocartilage Complex Tears in the Ulnar Positive Patient: Arthroscopic Repair Versus Ulnar Shortening Osteotomy

Hand: Bone and Ligament


Management of Peripheral Triangular Fibrocartilage Complex Tears in the Ulnar Positive Patient: Arthroscopic Repair Versus Ulnar Shortening Osteotomy


Papapetropoulos PA, Wartinbee DA, Richard MJ, et al (Duke Univ Med Ctr, Durham, NC) J Hand Surg 35A:1607-1613, 2010§



D.G. Dennison, MD



Evidence Ranking


• B



Expert Rating


• 2



Abstract



Purpose


One pattern of injury to the triangular fibrocartilage complex (TFCC) is a traumatic peripheral tear located at the ulnar end of the TFCC. Since 1989, this specific injury has been classified as a Palmer type 1B lesion. Various treatment options have been described for 1B injuries, yet when there is coexistent ulnar positive variance, it can make the choice of treatment difficult. The purpose of this article is to help the surgeon decide how to treat type 1B lesions in ulnar positive patients by directly comparing arthroscopic repair (repair) to ulnar shortening osteotomy (USO). The null hypothesis was that repair and USO would provide equivalent postoperative improvement with regard to motion; Disability of the Arm, Shoulder, and Hand (DASH) score; visual analog scale (VAS) score; and grip strength.



Methods


We tested our hypothesis by retrospectively reviewing prospectively collected data from 51 patients treated surgically between 2000 and 2006 with type 1B tears in the setting of ulnar positive variance. Of these 51 patients, 27 were treated with arthroscopic repair and 24 with USO. All patients were evaluated before surgery as well as at final follow-up for active range of motion measurements, grip strength, DASH score, and VAS score. Radiographs were taken of all patients before surgery to confirm the presence of ulnar positive variance, and after surgery in the USO group to evaluate for bony union.

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Apr 2, 2016 | Posted by in Hand surgery | Comments Off on of Peripheral Triangular Fibrocartilage Complex Tears in the Ulnar Positive Patient: Arthroscopic Repair Versus Ulnar Shortening Osteotomy

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