Arthroscopic Wafer Procedure for Ulnar Impaction Syndrome in an Intact Triangular Fibrocartilage Complex

Area of Science:

• Orthopedic Surgery
• Wrist Arthroscopy
• Sports Medicine

Background:

• Ulnar abutment syndrome causes wrist pain due to abnormal loading on the ulnar side.
• Traditional treatments include ulnar shortening osteotomy and wafer procedures (open or arthroscopic).
• Arthroscopic wafer resection typically requires triangular fibrocartilage complex perforation, posing a challenge for intact cases.

Purpose of the Study:

• To describe a novel arthroscopic technique for the wafer procedure in patients with ulnar abutment and an intact triangular fibrocartilage complex.
• To evaluate the feasibility and outcomes of this modified arthroscopic approach.
• To offer an alternative to open surgery or creating iatrogenic perforations.

Main Methods:

• Arthroscopic technique performed in the space between the triangular fibrocartilage complex and the ulnar dome.
• No central perforation of the triangular fibrocartilage complex was created.
• Procedure focused on addressing ulnar impaction symptoms in a specific patient subgroup.

Main Results:

• The described arthroscopic technique allows for effective wafer resection without central triangular fibrocartilage complex perforation.
• The procedure yielded outcomes comparable to established arthroscopic wafer procedures.
• Demonstrates successful management of symptomatic ulnar abutment in cases with intact triangular fibrocartilage complex.

Conclusions:

• A modified arthroscopic wafer procedure is a viable option for ulnar abutment syndrome with an intact triangular fibrocartilage complex.
• This technique avoids the need for triangular fibrocartilage complex perforation, preserving its integrity.
• It offers a less invasive alternative to open surgery for selected patients.