Triangular Fibrocartilage Complex Repair and Ulna Variance: A Systematic Review

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Hand and Wrist Surgery

Background:

• Peripheral tears of the triangular fibrocartilage complex (TFCC) are common wrist injuries.
• Ulnar variance, the relative length of the ulna compared to the radius, is a potential factor influencing TFCC tear outcomes.

Purpose of the Study:

• To systematically review the existing literature on the association between ulnar variance and clinical outcomes following surgical repair of peripheral TFCC tears.

Main Methods:

• A systematic literature search identified seven relevant studies for evaluation.
• Study quality was assessed using the Structured Effectiveness Quality Evaluation Scale (SEQES) and Sackett's Level of Evidence (LOE).
• Outcomes were measured using objective or self-assessment scoring systems for hand, wrist, or upper extremity function.

Main Results:

• Five of the seven studies found no significant association between ulnar variance and clinical outcomes.
• Two studies reported a positive association.
• Studies reporting no association often excluded or did not specify cases with unstable distal radioulnar joint (DRUJ).

Conclusions:

• Current evidence is insufficient to strongly support or refute a link between ulnar variance and outcomes after TFCC repair.
• Further research is required, specifically differentiating between tear types (capsular vs. foveal) that impact DRUJ stability.
• Clarifying this relationship may inform the utility of ulnar shortening osteotomy for improving TFCC repair outcomes.