Getting a Grip on Triangular Fibrocartilage Complex Tears: A Retrospective Comparative Study on Triangular...

Area of Science:

• Orthopedic Surgery
• Wrist Biomechanics
• Radiology

Background:

• Triangular fibrocartilage complex (TFCC) tears are a common cause of wrist pain.
• Debridement is a surgical option for TFCC tears, but outcomes can vary.
• Ulnar variance, a measure of the relative length of the ulna and radius, may influence TFCC tear progression and surgical success.

Purpose of the Study:

• To compare clinical outcomes and complications following TFCC debridement based on dynamic ulnar variance.
• To investigate the relationship between gripping posteroanterior (PA) view ulnar variance and patient recovery.

Main Methods:

• Retrospective analysis of 30 patients undergoing TFCC debridement.
• Group A: Ulnar variance <1.0 mm (standard PA) and ≥1.0 mm (gripping PA).
• Group B: Ulnar variance <1.0 mm (standard and gripping PA).
• Outcomes assessed: return to work, VAS pain scores, range of motion, and complications.

Main Results:

• Group A showed significantly lower return-to-work rates (7/17 vs. 1/13) and higher persistent pain (10/17 vs. 2/13).
• Group A had worse mean VAS scores (5.3 vs. 2.0) and reduced range of motion (flexion-extension: 110° vs. 130°; pronation-supination: 161° vs. 174°).
• Seven patients in Group A required revision surgery, compared to none in Group B.

Conclusions:

• TFCC debridement patients with dynamic positive ulnar variance (Group A) experienced inferior clinical outcomes.
• Dynamic ulnar variance, assessed via gripping PA views, may be a critical factor in predicting success after TFCC debridement.
• Further research into dynamic ulnar variance assessment is warranted for optimizing treatment strategies.