• J Hand Surg Am · May 2016

    Comparative Study

    The Outcomes of Arthroscopic Repair Versus Debridement for Chronic Unstable Triangular Fibrocartilage Complex Tears in Patients Undergoing Ulnar-Shortening Osteotomy.

    • Joong-Bae Seo, Jong-Pil Kim, Hyung-Suk Yi, and Kwang-Hee Park.
    • Department of Orthopedic Surgery, College of Medicine, Dankook University, Cheonan, Korea; Department of Kinesiology and Medical Science, Graduate School, Dankook University, Cheonan, Korea.
    • J Hand Surg Am. 2016 May 1; 41 (5): 615-23.

    PurposeThe aim of this study was to compare the results of arthroscopic peripheral repair (AR) and arthroscopic debridement (AD) for the treatment of chronic unstable triangular fibrocartilage complex (TFCC) tears in ulnar-positive patients undergoing ulnar-shortening osteotomy (USO).MethodsA total of 31 patients who underwent arthroscopic treatments combined with USO for unstable TFCC tears and were followed-up at a minimum of 24 months were included in this retrospective cohort study. Fifteen patients were treated with AR, and 16 patients were treated with AD while at the same time undergoing a USO. Outcome measures included wrist range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) and Patient-Rated Wrist Evaluation (PRWE) scores, and overall outcomes according to the modified Mayo wrist scoring system. In addition, a stress test to assess distal radioulnar joint (DRUJ) stability was performed before and after surgery to compare the 2 cohorts.ResultsBoth respective cohorts showed significant improvements in grip strength and subjective scores at the final follow-up. Grip strength, DASH, and PRWE scores were better in the AR group than in the AD group. The recovery rate from DRUJ instability observed during the preoperative examination was superior in the AR group.ConclusionsBoth AD and AR of the TFCC combined with USO are reliable procedures with satisfactory clinical outcomes for unstable TFCC tears in ulnar-positive patients. However, AR of the TFCC is suggested if DRUJ stability is concomitantly compromised.Type Of Study/Level Of EvidenceTherapeutic IV.Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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