Ulnar shortening for triangular fibrocartilage complex tears associated with ulnar positive variance

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Sports Medicine

Background:

• Triangular fibrocartilage complex (TFCC) tears can cause significant wrist pain and dysfunction.
• Ulnar positive variance is a common contributing factor to TFCC tears.
• Conservative management often fails for TFCC tears with ulnar positive variance.

Purpose of the Study:

• To evaluate the efficacy of ulnar shortening osteotomy in patients with TFCC tears and ulnar positive variance.
• To assess pain relief, functional improvement, and complications following ulnar shortening.

Main Methods:

• Twenty-five patients with TFCC tears and ulnar positive variance underwent ulnar shortening.
• Arthroscopy was performed in 23 patients to classify TFCC tears and assess degenerative changes.
• Ulnar shortening averaged 3 mm, with transverse osteotomies.

Main Results:

• Twenty-three of 25 patients reported complete or occasional mild pain relief.
• Arthroscopic findings revealed 15 class 1 and 8 class 2 TFCC tears.
• Osteotomies healed in all patients within 7 weeks; 7 patients showed minor distal radioulnar joint degeneration.

Conclusions:

• Ulnar shortening is a viable surgical option for TFCC tears associated with ulnar positive variance.
• The procedure offers significant pain relief and functional recovery for select patients.
• Potential complications include reflex sympathetic dystrophy and osteotomy site fractures.