Artikel
Does Degeneration of Triangular Fibrocartilage Complex Improve after Ulnar Shortening Osteotomy?
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Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: The degeneration of the triangular fibrocartilage complex (TFCC) is usually combined in patients with ulnar impaction syndrome. Because ulnar shortening osteotomy can decrease the load-sharing through the ulnar carpus, there may be a possibility of indirect healing of TFCC degeneration after ulnar shortening. In this study, we focused on the changes of the TFCC degeneration after ulnar shortening osteotomy using 3D CT wrist arthrography.
Methods: We retrospectively reviewed all patients who were diagnosed as ulnar impaction syndrome and underwent ulnar shortening osteotomy from January 2014 to December 2016. Of them, we enrolled 18 wrists of 15 patients who had checked 3D CT wrist arthrography preoperatively and checked postoperative CT wrist arthrography repeatedly one year after surgery. The average age at the time of surgery was 37 years.
Results and Conclusions: In all patients, the degeneration of TFCC was observed in preoperative CT wrist arthrography. Six wrists were IIA, three were IIB, seven were IIC, and one was IID according to Palmer classification. One year after surgery, the degeneration of TFCC improved in three wrists, and worsened in two wrists. In the other twelve wrists, there were no changes in the degeneration of TFCC. The average visual analog scale (VAS) for pain was improved from 7 (range, 5~9) preoperatively to 3 (range, 0~6) one year after surgery. Although ulnar side wrist pain was much improved after ulnar shortening osteotomy, indirect healing of the TFCC degeneration was not observed in most of our cases one year after surgery. Therefore, we can conclude that indirect healing of the TFCC degeneration may need more time or may not occur after ulnar shortening osteotomy. The degeneration of the TFCC may not seem to be the main cause of the ulnar side wrist pain in patients with ulnar impaction syndrome.