Dorsal Intercarpal Ligament Tears: An Arthroscopic Classification and Clinical Outcomes Study

Background  The dorsal intercarpal (DIC) ligament plays a significant role in carpal stability and is often associated with other carpal ligament injuries. Isolated DIC ligament injuries are rare and can present as a ligament avulsion, bony avulsion, or attenuation due to chronic injury. Previously, we described the first isolated DIC ligament avulsion and proposed an arthroscopic repair technique. This article presents an arthroscopic classification of DIC ligament complex injuries and outcomes in a larger series of patients. Materials and Methods  A retrospective review was conducted on 16 patients who had undergone arthroscopic repair of the DIC ligament from 2018 to 2022. Intraoperative arthroscopic findings were documented, leading to the proposal of a classification system for DIC ligament tears. Pre- and postoperative outcomes, including the range of motion, grip strength, visual analog scale (VAS) pain scores, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) outcomes, were assessed in this cohort. Results  At a mean follow-up of 17.8 months, there was a statistically significant improvement in wrist flexion (65.3 to 74.3 degrees), wrist extension (77.8 to 84.5 degrees), comparative grip strength (46.4 to 87% compared with contralateral wrist), VAS score (6.3 to 0.6), and QuickDASH score (54.8 to 4.5). Four out of 16 patients (25%) had isolated DIC ligament tears, and the remaining 12 (75%) had concomitant intercarpal ligament injuries. Conclusion  The study highlights the critical role of the DIC ligament in carpal stability and introduces an arthroscopic classification for evaluating this lesion. Surgical options for different types of DIC ligament tears were also discussed. Level of Evidence  Level III, Retrospective study.