gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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The Ulnar Plus Variance Does Not Adversely Affect the Outcomes of Arthroscopic Repair for Triangular Fibrocartilage 1b Tear

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  • presenting/speaker Bong Cheol Kwon - Department of Orthoepdic Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea
  • Jae-Yeon Hwang - Department of Orthoepdic Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-558

doi: 10.3205/19ifssh0880, urn:nbn:de:0183-19ifssh08809

Published: February 6, 2020

© 2020 Kwon et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: There has been a debate regarding the effect of ulnar plus variance (UPV) in the outcomes of arthroscopic repair for TFCC 1b tear. The purpose of this study was to compare the outcomes of arthroscopic repair for TFCC 1b tear between patients with UPV and those without UPV, and to identify risk factors for revision surgery with ulnar shortening osteotomy (UPV).

Methods: We retrospectively analyzed 38 consecutive patients (21 patients with UPV) and 17 patients without UPV) receiving arthroscopic repair for TFCC 1b tear from June 2014 to February 2017. We evaluated the patients with pain visual analogue scale (VAS) at three domains (overall, at hard work, and at rest), Patient-Rated Wrist Evaluation (PRWE), range of motion, and grip strength. Clinical outcomes and arthroscopic findings were compared between the patients with UPV (UPV group) and those without UPV (non-UPV group). A multivariate logistic regression model was used to determine the risk factors for revision surgery with USO.

Results and Conclusions: Demographic data were comparable between the groups (P > 0.05). The subtypes of TFCC 1b tear, signs of ulnocarpal abutment, and the incidence of concomitant intercarpal ligament injuries were not significantly different between the groups (P>0.05). Post-operative outcomes were also similar between the groups regarding the scores for pain VAS and PRWE, and the rates of the patients of the excellent or improved outcomes (P>0.05). The co-existing degenerative central TFCC tear was the only significant risk factor for revision surgery (OR, 30.2; 95% confidence interval, 1.83-500.28; P=0.017) after being adjusted for age and sex.

In conclusion, the ulnar plus variance did not significantly affect the outcomes of arthroscopic repair for TFCC 1b tear, suggesting that simultaneous ulnar shortening osteotomy is not necessary for the patients with UPV. However, the co-existing signs of degenerative central TFCC tear significantly increased the risk of revision surgery with USO.