MRI Findings in Patients Undergoing Triangular Fibrocartilage Complex Repairs Versus Patients Without Ulnar-Sided Wrist Pain. (May 2022)

• Record Type: Journal Article
• Authors: Verhiel, Svenna H. W. L.; Blackburn, Julia; Ritt, Marco J. P. F.; Simeone, Frank J.; Chen, Neal C.
• Is Part Of: Hand. Volume 17:Number 3(2022)
• Page Start: 483
• Page End: 490
• Publication Date: 2022-05
• Subjects: MRI -- radiology -- triangular fibrocartilage complex -- ulnar-sided wrist pain; Hand -- Surgery -- Periodicals; Hand -- Surgery; Periodicals; 617.57005
• DOI: 10.1177/1558944720937369
• Languages: English
• ISSNs: 1558-9447

Abstract

Background: The clinical picture of ulnar-sided wrist pain is oftentimes confusing because various pathologies may be coexistent. In this study, we aimed: (1) to compare the prevalence of potential causes of ulnar-sided wrist pain on magnetic resonance imaging (MRI) in patients who underwent triangular fibrocartilage complex (TFCC) repair and control subjects: and (2) to evaluate whether inferior clinical results were associated with specific patient characteristics or other potential causes of ulnar-sided wrist pain.Methods: We included 67 patients who underwent a TFCC repair and 67 control subjects. The MRI scans were examined for sources of ulnar-sided wrist pain. After TFCC repair, 42 patients (63%) completed surveys, including Quick Disabilities of the Arm, Shoulder and Hand and pain scores. Bivariate analysis was performed to compare our groups and to identify factors associated with our outcomes.Results: We found significantly higher rates of distal radioulnar joint (DRUJ) arthritis ( P = .033), extensor carpi ulnaris (ECU) pathology ( P = .028), and ulnar styloid fractures ( P = .028) in patients with TFCC repairs. With increasing age, increasing pathology in the pisotriquetral joint ( P = .040), more ulnocarpal abutment ( P = .0081), and more degenerative tears ( P < .001) were seen in both groups. No demographic characteristics or MRI findings were significantly associated with our outcomes.Conclusions: We observed higher rates of DRUJ arthritis and ECU pathology in patients with TFCC tears undergoing repair compared with age- and sex-matched controls. This may be due to damage to the TFCC itself altering relationships of the DRUJ and the ECU subsheath, or it may reflect various pathologies that cause ulnar-sided wrist pain and drive patients toward surgery.