Outcomes following Arthroscopic Ulnotriquetral Split Tear Repair
Nicholas J Clark, MD1; Nicholas Munaretto, MD1; David Ivanov, BS1; Sanjeev Kakar, MD2
1Mayo Clinic, Rochester, MN, 2Department of Orthopedics, Mayo Clinic, Rochester, MN
Introduction: Ulnar sided wrist pain is a common cause of upper extremity disability. While the mechanism and clinical presentation of ulnotriquetral (UT) ligament split tears has been described, there is limited data regarding the outcomes of this condition. The purpose of this study was to assess the functional and clinical outcomes of patients undergoing arthroscopic UT ligament split tear repair.
Methods: 228 wrists (142 right and 86 left) in 221 patients (100 males and 128 females, mean age 35 ± 15.5, range 14-77 years) underwent UT ligament split tear repair between 2007 and 2016. Mayo wrist score, Visual Analogue Scale (VAS) pain scores, and objective measures including grip strength and range of motion were obtained. Patients were followed with a mean follow up of 10.3 months. The comparison between preoperative and postoperative outcomes was performed with a paired t-test. The ? level was set to 0.05. All statistical analyses were conducted using JMP®, Version 13.0.0, SAS Institute Inc., Cary, NC, 1989-2007.
Results: Ulnotriquetral split tear repair resulted in substantial improvements in pain and function. Mayo Wrist Score for the cohort improved from 56 preoperatively to 82 postoperatively (p<0.0001), and 83% of patients achieved a good or excellent outcome. VAS pain scores decreased from 6.0 preoperatively to 1.4 postoperatively (p<0.0001). Grip improved from 26.1 kg preoperatively to 29.8 kg postoperatively (p=0.003). There was no significant change in range of motion of the wrist. Complications were noted in 13 patients with 8 experiencing continued pain, 4 with dysesthesia of the dorsal sensory ulnar nerve and 1 superficial infection.
Conclusion: In the largest series reported to date, arthroscopic repair of UT split tears provides predictable pain relief, improved function, and low complication rate.
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