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J Wrist Surg
DOI: 10.1055/s-0044-1787751
Scientific Article

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

Ather Mirza
1   North Shore Surgi-Center, Smithtown, New York
2   Mirza Orthopedics, Smithtown, New York
3   Stony Brook University, Stony Brook, New York
,
Justin B. Mirza
1   North Shore Surgi-Center, Smithtown, New York
2   Mirza Orthopedics, Smithtown, New York
3   Stony Brook University, Stony Brook, New York
4   New York Institute of Technology, Old Westbury, New York
,
Luke C. Zappia 
2   Mirza Orthopedics, Smithtown, New York
4   New York Institute of Technology, Old Westbury, New York
,
Terence L. Thomas
5   Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
,
Junho Song
6   Icahn School of Medicine at Mount Sinai Hospital, Department of Orthopedic Surgery, New York, New York
› Author Affiliations Funding None.
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Abstract

Background A retrospective analysis was performed to compare the clinical outcomes and complications of patients who underwent triangular fibrocartilage complex (TFCC) debridement based on gripping posteroanterior (PA) view ulnar variance measures.

Methods Patients in Group A (N = 17) demonstrated ulnar variance measures <1.0 mm on the standard PA view and ≥1.0 mm on the gripping PA view. Patients in Group B (N = 13) maintained ulnar variance measures <1.0 mm on standard and gripping PA views. Clinical outcome measures included return to work, visual analog scale (VAS) scores, and range of motion. Complications included persistent pain, postoperative injections, and indication for revision surgery. Qualitative and quantitative measures were analyzed using Fisher exact tests and Student's t-tests, respectively.

Results Significantly more patients in Group A (7/17) did not return to work compared with Group B (1/13) (p < 0.05). Mean VAS scores decreased from 7.0 to 5.3 in Group A and from 6.8 to 2.0 in Group B. Group A reported lower flexion–extension and pronation–supination arcs compared with Group B (110 vs. 130 degrees and 161 vs. 174 degrees) (p < 0.05). Significantly more patients in Group A (10/17) reported persistent pain at ≥3 months postoperatively compared with Group B (2/13) (p < 0.05). Seven cases were indicated for revision surgery in Group A, while no cases were indicated in Group B (p < 0.05).

Conclusion Patients in Group A reported inferior clinical outcomes compared with Group B based on pain, range of motion, and indication for revision surgery. Dynamic ulnar variance may play a role in the clinical outcomes of patients treated with TFCC debridement.

Level of Evidence Level IV.

Type of Study/Level of Evidence Retrospective Comparative Study/Level IV.

Keywords

triangular fibrocartilage complex - ulnar variance - gripping - posteroanterior view - arthroscopic debridement - ulnar-sided wrist pain

Informed Consent

Informed consent was waived in accordance with the institutional protocol.


Statement of Human and Animal Rights

This study has been reviewed by an Institutional Review Board and was determined exempt. Informed consent was waived in accordance with institutional protocol. All procedures are in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and in accordance with the ethical principles underlying the involvement of human subjects in research (including the Belmont Report, the Nuremberg Code, and the Declaration of Helsinki). Record-keeping was in compliance with the Health Insurance Portability and Accountability Act.




Publication History

Received: 30 January 2024

Accepted: 21 May 2024

Article published online:
05 July 2024

© 2024. Thieme. All rights reserved.

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