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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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Arthroscopic treatment for isolated traumatic lunotriquetral ligament injury without triangular fibrocartilage complex lesion

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  • presenting/speaker Byungsung Kim - Soonchunhyang University, Bucheon-si, South Korea
  • Keonhee Yun - Soonchunhyang University, Bucheon-si, South Korea
  • WhiJe Cho - Soonchunhyang University, Bucheon-si, 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. DocIFSSH19-275

doi: 10.3205/19ifssh0956, urn:nbn:de:0183-19ifssh09565

Published: February 6, 2020

© 2020 Kim 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: To evaluate the clinical results of patients treated by arthroscopic debridement and thermal shrinkage of the isolated traumatic lunotriquetral(LT) ligament tear without triangular fibrocartilage complex(TFCC) tear.

Methods: We retrospectively reviewed the results for 12 patients (10 men, 2 women; mean age, 30 years) who underwent arthroscopic debridement and thermal shrinkage for the treatment of isolated traumatic LT ligament membraneous portion tear at our hospital.

The patients were followed for a mean of 9 months. The patients had isolated traumatic LT ligament tear caused by: sprain (N=6); falls (N=5); and boxing (N=1). All the patients underwent MRI. The radiographs for ulnar variance (UV), ulnar dorsal subluxation, and function of the wrist using grip power, DASH score, and Mayo wrist score were examined in all the patients both preoperatively and postoperatively.

Results and Conclusions: For the preoperative MRI, LT ligament tear was not definitely observed in all cases excepting distal radioulnar joint (DRUJ) subluxation in 8, lunate bony contusion in 2, ulnar styloid bony contusion in 1 and occult ganglion of dorsal scapholunate ligament in 2. The average duration from trauma to surgery was 5 months. Preoperative ulnar stress test was positive in 8, DRUJ stress in 7, ballottement test in 7 and supination limitation in 1 case. The average values for the preoperative simple radiographic findings were: UV, 2.6 mm; and dorsal subluxation at the distal ulna, 1.0 mm. Arthroscopically LT tear type was flap tear in 10 and bucket handle tear in 2. In all the cases, the pain improved postoperatively (VAS: from 4 to 1.5). Grip power (compared to the uninvolved limb) was 66% preoperatively and 81% postoperatively. The DASH scores were 36.8 points preoperatively and 7 points postoperatively. The Mayo wrist scores were excellent in 3 cases, good in 8 cases, and fair in 1 cases, and the average score improved significantly from 68 points preoperatively to 87 points postoperatively. Two patients experienced ECU tendinitis.

LT ligament tear should be differentiated from TFCC lesion when the patients is presented with ulnar wrist pain because MRI cannot detect LT ligament tear. Arthroscopic debridement and thermal shrinkage for the treatment of isolated traumatic LT ligament tear can reduce pain.