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Outcomes of Arthroscopic Treatment for Radiocarpal Instability with Ulnar Carpal Translation and Triangular Fibrocartilage Complex Tear
Chih-Hsun Chang, M.D.; Hui-Kuang Huang, M.D.
Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
IntroductionThe presence of ulnar carpal translation (UCT) increases the risk of Triangular fibrocartilage complex (TFCC) injury. This study aims to evaluate the outcomes of arthroscopic treatment in patients with radiocarpal instability associated with UCT and TFCC tears.
MethodsWe retrospectively reviewed patients with ulnar carpal translation (UCT, lunate overhang >44%) and MRI-confirmed TFCC tears treated between 2016 and 2024, with at least one year of follow-up. The operative group received arthroscopic thermal shrinkage of the RSC and LRL ligaments and TFCC repair. A non-operative group with similar conditions was included for comparison. Outcomes were assessed using QuickDASH, VAS pain scores, and wrist range of motion.
ResultsEleven patients in the operative group and eight in the non-operative group were enrolled. The surgical group showed significantly better pain relief, functional outcomes, and wrist range of motion at final follow-up, despite undergoing ligament repair and thermal shrinkage. However, the lunate overhang percentage remained unchanged postoperatively.
DiscussionThe RSC and LRL ligaments are key structures in maintaining radiocarpal stability. In cases of TFCC injury, it is important to carefully assess the condition of radiocarpal instability, as UCT may contribute to TFCC injury or even increase the risk of TFCC repair failure. Although UCT cannot be reduced to its original position, improving radiocarpal stability can enhance the surgical outcomes of TFCC repair.
ConclusionArthroscopic treatment for patients with UCT and TFCC tears is worthwhile, as it leads to improved functional outcomes compared to non-surgical treatment.
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