How Does Ulnar Shortening Osteotomy Influence Morphologic Changes in the Triangular Fibrocartilage Complex?

Yamanaka, Yoshiaki; Nakamura, Toshiyasu; Sato, Kazuki; Toyama, Yoshiaki

doi:10.1007/s11999-014-3854-9

Cited by 8 publications

(5 citation statements)

References 16 publications

(32 reference statements)

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“…The observers selected the mid-coronal slice, where the TFC appeared the thinnest. In this slice, the shortest distance between the two articular surfaces of the disc was measured, similar to earlier reported methods (Iordache et al., 2012; Yamanaka et al., 2014; Yoshioka et al., 2007) (Figure 1(a)). In case central TFC thickness could not be assessed due to a hyperintense signal intensity disrupting the disc at its thinnest point, observers were instructed by the score form to report a value of zero (Figure 1(b)).…”

Section: Methodssupporting

confidence: 74%

Ulnar variance and triangular fibrocartilage thickness in adolescents: a cross-sectional MRI study of healthy participants

Post

Jens

Jacobs

et al. 2022

J Hand Surg Eur Vol

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Skeletally immature wrists are considered at risk of injury due to increased axial loading through a relatively shorter ulna. The aim of this study was to determine whether triangular fibrocartilage thickness relates to ulnar variance and age in adolescents. The radiographs and MRIs of 24 healthy adolescents were retrospectively assessed. Four observers assessed bone age and ulnar variance on radiographs and measured triangular fibrocartilage thickness on MRIs. Median calendar and bone age was 13 years and ulnar variance was −0.7 mm. Median triangular fibrocartilage thickness was 1.4 mm, with excellent inter-observer agreement (r = 0.86). It was moderately correlated with ulnar variance (ρ = −0.46) as well as with bone age (ρ = −0.49). Both variables were statistically significant predictors in a multivariate analysis. This suggests that triangular fibrocartilage thickness changes during skeletal maturation, which might influence axial load distribution in skeletally immature wrists.

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Section: Methodssupporting

confidence: 74%

Ulnar variance and triangular fibrocartilage thickness in adolescents: a cross-sectional MRI study of healthy participants

Post

Jens

Jacobs

et al. 2022

J Hand Surg Eur Vol

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“…Another unique study by Yamanaka et al 24 highlighted the effect of variance correction on TFCC and correlated the results with clinical impaction on MMW score. A total of 79 patients with commplete data who underwent USO for TFCC injuries were included.…”

Section: Discussionmentioning

confidence: 99%

Combined Arthroscopic Wafer Procedure and Triangular Fibrocartilage Complex Debridement versus Ulnar Shortening Diaphyseal Osteotomy in Management of Ulnar Impaction Syndrome: A Randomized Clinical Trial

El-Tayar,

El-Ghandour,

Ghazal

et al. 2023

J Wrist Surg

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Background The literature presents great challenge in comparing the arthroscopic wafer procedure (AWP) versus ulnar shortening osteotomy (USO) in the treatment of ulnar impaction syndrome (UIS). Purpose We aimed primarily to compare the clinical and functional outcomes of AWP with triangular fibrocartilage complex (TFCC) debridement versus USO in the management of UIS. Methods The study was conducted as a randomized clinical trial including 43 patients with UIS whose ulna variance was less than 4 mm. Patients were randomly allocated to either the AWP group (21 patients) who underwent AWP and TFCC debridement or the USO group (22 patients) who underwent diaphyseal USO. Patients were followed up for at least 12 months. The primary outcome measure was the Modified Mayo Wrist (MMW) score. The Disabilities of the Arm, Shoulder, and Hand (DASH) score, the mean operative time, postoperative complications, and patient satisfaction were our secondary outcomes. Results Radiological correction of variance was achieved in all patients. The mean operative time was significantly shorter in the AWP group. The postoperative MMW and DASH scores were better in the AWP group than in the USO group. Fewer complications occurred in the AWP group (1 of 21 patients) compared with the USO group (3 of 22 patients). Conclusions AWP with TFCC debridement is a reliable and safe method for the management of UIS with a positive variance of less than 4 mm with better clinical and functional results than diaphyseal USO. Type of study/level of evidence Therapeutic type II.

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“…Yamanaka et al reported that positive UV affects the regeneration of TFCC. 88 Therefore, USO alone was used as a treatment for TFCC injury to increase the tautness of the ulnar collateral ligament and IOM and to decrease the load on the TFCC. 15,89,90 Papapetropoulos et al reported that USO showed an equivalent effect to TFCC repair in type 1B TFCC tears with positive UV patients.…”

Section: Ulnar Shortening Osteotomy and Triangular Fibrocartilage Com...mentioning

confidence: 99%

Ulnar Impaction Syndrome and TFCC Injury: Their Relationship and Management

Im,

Lee,

Lee

2023

J Wrist Surg

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Ulnar-sided wrist pain can be caused by a number of problems, including ulnar impaction syndrome (UIS) and triangular fibrocartilage complex (TFCC) injury. Multiple studies have described the diagnostic criteria for UIS and TFCC injuries, and excellent surgical outcomes have been reported for each condition. Few studies have examined the extent to which the two independent conditions cooccur, and little is known about their relationship. Based on theories in the literature and clinical experience, we propose the possibility of TFCC injury as the cause and result of UIS in this review.

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How Does Ulnar Shortening Osteotomy Influence Morphologic Changes in the Triangular Fibrocartilage Complex?

Abstract: Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

Cited by 8 publications

References 16 publications

Ulnar variance and triangular fibrocartilage thickness in adolescents: a cross-sectional MRI study of healthy participants

Ulnar variance and triangular fibrocartilage thickness in adolescents: a cross-sectional MRI study of healthy participants

Combined Arthroscopic Wafer Procedure and Triangular Fibrocartilage Complex Debridement versus Ulnar Shortening Diaphyseal Osteotomy in Management of Ulnar Impaction Syndrome: A Randomized Clinical Trial

Ulnar Impaction Syndrome and TFCC Injury: Their Relationship and Management

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