Treatment of Distal Radioulnar Joint Subluxation with Repair of Triangular Fibrocartilage Complex

To evaluate the efficacy of repair for triangular fibrocartilage tears with distal radiolnar joint subluxation, we investigated the functional outcome in 13 retrospective cases (in 12 patients) of ulnar wrist pain. Distal radioulnar joint subluxation (all ulna dorsal) and tears of triangular fibrocartilage complex (13 ulnar, 2 volar, and 3 radial tears) were found in all cases by CT-arthrogram and arthroscopy of the wrist. Advancement and tightening of the tightening of the lax dorsal radioul-nar ligament and the infratendinous sheath of the extensor carpi ulnaris to the dorsal edge of sigmoid notcj of radius with a Fastak screw suture anchor was done with the wrist held in full supination. Ulnar and volar tears of the triangular fibrocartilage complex were rapaired through the same dorsoulnar wrist incision, while radial tears were repaired arthroscopically. The wrist was immpbilized in full supination with a long arm splint. Mayo wrist score was used to assess wrist function before and 6 months after the primary repair. The average pain, functional, motion, and grip scores improved after surgery, increasing from 3.8 ± 5.1 to 22.3 ± 4.1, 7.7 ± 4.4 to 21.9 ± 4.3, 12.7 ± 7.9 to 21.8 ± 5.1, 12.3±6.1 to 20 ± 5.5, respectively (P＜0.01). The percentage of ulna dorsal subluxation was reduced from 48.5 to 22.3% after surgery. We conclude that: (1) These repairs improve wrist function. (2)Advancement and tightening of the lax dorsal radioulnar ligament and the infratendinous sheath of the extensor carpi ulnaris to the distal radius fooers an effective alternative to reduce subluxation of the distal radioulnar joint.(3)CT scanning of both wrist joints is useful for assessing the extent of reduction.

並列關鍵字

Distal radiolnar joint ； Subluxation ； Triangular fibrocartilage complex ； Rapair

國際替代計量

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