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Triangular fibrocartilage complex tears associated with symptomatic ulnar styloid nonunions
Themistocles S Protopsaltis1, David S Ruch
1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA.
The Journal of Hand Surgery
|August 6, 2010
Summary
Symptomatic ulnar styloid nonunions often accompany triangular fibrocartilage complex (TFCC) tears. Concurrent arthroscopic TFCC repair and open ulnar styloid excision effectively treat these combined wrist injuries, improving patient outcomes.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Sports Medicine
Background:
- Triangular fibrocartilage complex (TFCC) tears and ulnar styloid nonunions are common after upper extremity injuries.
- Ulnar styloid fractures are frequent in distal radius fractures, but symptomatic nonunions occur less often.
Purpose of the Study:
- To confirm the association between symptomatic ulnar styloid nonunions and TFCC tears.
- To report intra-articular findings and clinical outcomes of combined arthroscopic TFCC repair and open ulnar styloid nonunion excision.
Main Methods:
- Retrospective review of 8 patients undergoing open ulnar styloid nonunion excision and arthroscopy.
- Preoperative MRI used for TFCC tear diagnosis in 5 of 8 patients.
- Outcomes assessed using Disabilities of the Arm, Shoulder, and Hand (DASH) and visual analog scale (VAS) for pain.
Main Results:
- Arthroscopy revealed full-thickness chondral injury on the triquetrum, dorsal radiolunotriquetral ligament tears, and TFCC avulsion.
- Statistically significant improvement in DASH and VAS pain scores postoperatively (p<.05).
Conclusions:
- Symptomatic ulnar styloid nonunions are associated with TFCC tears.
- Diagnostic arthroscopy is recommended for patients undergoing ulnar styloid nonunion excision.
- Combined arthroscopic TFCC repair and open ulnar styloid excision is an effective treatment.
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