Ulnar shortening after TFCC suture repair of Palmer type 1B lesions

Abstract

Patients who have a dynamic ulna positive variance and experience persistent ulno-carpal symptoms following arthroscopic suture repair of a Palmer type 1B lesion, benefit from an ulnar shortening procedure. Shortening the ulna can improve these patients' symptoms of pain, range of motion, and grip strength.

Nerve Fiber Staining Investigations in Traumatic and Degenerative Disc Lesions of the Wrist

“…The wrist was distended with 5 to 10 mL sterile saline solution, and the arthroscope (2.4 mm) was introduced through the 3-4 portal in accordance with standard technique. 2 We diagnosed both types of lesions using a probe. The Palmer type 1A lesion presented with a linear tear into the disc, whereas the type 2C lesion presented with a round perforation within the visibility of the ulna head.…”

“…To date, however, the source of the pain remains unknown. [2][3][4] Previous anatomical and immunohistochemical investigations regarding the innervation of the TFCC were conducted using biopsies from cadaver discs and revealed no evidence of nerve fibers in the healthy disc. [5][6][7] In non-disc parts of the TFCC, however, nerve fibers could be detected.…”

Ulnar shortening with the ulna osteotomy locking plate

“…F Longitudinal forearm instability after radial head resection and remaining ulnar plus variance (Essex-Lopresti lesions) along with replacement of the radial head. F After failed arthroscopic debridement or suture of TFCC lesions in patients with positive ulnar variance [32]. F Alternative to arthroscopic TFCC repair of Palmer 1B lesions in patients with positive ulnar variance [21].…”

“…Furthermore, the ulnar shortening osteotomy is indicated in the primary treatment of TFCC lesions in patients with positive ulnar variance [16,21] or after failure of its arthroscopic repair [32]. It has also been reported to be effective for patients with ulnocarpal instability [8,11].…”

Persistent ulnar-sided wrist pain after treatment of triquetral dorsal chip fracture: six cases related to triangular fibrocartilage complex injury

“…It has been reported that in patients who do not respond to non-operative means of treatment, an arthroscopic evaluation is helpful for delineating ligamentous injuries and an arthroscopic debridement is also recommended [10]. In patients who still exhibit persistent ulnocarpal symptoms after arthroscopic treatment of Palmer type IB lesions, ulnar shortening is helpful to improve the symptoms of pain, range of motion and grip strength [11].…”