Wrist arthrography versus arthroscopy: A comparative study of 150 cases

Chung, Kevin C.; Zimmerman, Neal B.; Travis, Michael T.

doi:10.1016/s0363-5023(96)80008-6

Cited by 86 publications

(30 citation statements)

References 9 publications

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“…Arthroscopy is considered the reference standard, and identifies more lesions than arthrography. 14,15 Lunotriquetral ligament tears and peripheral TFCC tears are more difficult to identify with arthrography than SL ligament tears and central TFCC tears. 16 Correlation of symptoms with arthrographic findings is critical.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Ulnar-sided Wrist Pain: Evaluation and Treatment of Triangular Fibrocartilage Complex Tears, Ulnocarpal Impaction Syndrome, and Lunotriquetral Ligament Tears

Sachar¹

2012

The Journal of Hand Surgery

147

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Section: Imaging Modalitiesmentioning

confidence: 99%

Ulnar-sided Wrist Pain: Evaluation and Treatment of Triangular Fibrocartilage Complex Tears, Ulnocarpal Impaction Syndrome, and Lunotriquetral Ligament Tears

Sachar¹

2012

The Journal of Hand Surgery

147

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“…Arthroscopy is considered the reference standard, and it identifies more lesions than arthrography does. 28 The hand was suspended with 3-5 kg of traction for arthroscopy, reduced to 2 kg for the ulnar shortening osteotomy procedure. We assessed the joint arthroscopically for the following: TFCC lesions, cartilage lesions, carpal instabilities, and synovitis.…”

Section: Surgical Techniquementioning

confidence: 99%

Ulnar Shortening Osteotomy for Ulnar-Sided Wrist Pain

et al. 2014

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The ulnar side of the wrist has been referred to as the "black box" of the wrist, and pathologies of this region have been compared with those of low back pain, 1,2 given the complex anatomy, myriad differential diagnosis, and varied treatment outcomes. Ulnar-sided wrist pain and arise from an acute traumatic injury or a chronic degenerative condition. Common causes of ulnar-sided wrist pain include isolated injuries to the triangular fibrocartilage complex (TFCC) or lunotriquetral ligament as well as ulnar impaction syndrome, which consists of a combination of these 2 conditions along with an Keywords ► ulnar shortening osteotomy ► ulnar-sided wrist pain ► TFCC ► DRUJ ► arthroscopy AbstractBackground The purpose of ulnar shortening osteotomy is literally to shorten the ulna. It can tighten the triangular fibrocartilage complex (TFCC), ulnocarpal ligaments, and interosseous membrane. Nowadays, this method is used to treat ulnar-sided wrist pain, for which we have also started to use a treatment algorithm. The purpose of this study was to review the long-term and clinical results based on our algorithm. Materials and Methods We retrospectively reviewed 30 patients with ulnocarpal impaction syndrome after a minimum follow-up of 5 years (Group A) and then retrospectively evaluated 66 patients with recalcitrant ulnar wrist pain treated based on our algorithm (Group B). Description of Technique Ulnocarpal abutment was confirmed arthroscopically. The distal ulna was approached through a longitudinal incision between the extensor carpi ulnaris and flexor carpi ulnaris. We performed a transverse resection of the ulna fixed with a small locking compression plate. The contralateral side served as the reference for the length of shortening (mean, 2.4 mm; range, 1-5 mm). Disappearance of ulnar abutment was then confirmed again arthroscopically. Results (Group A) Most patients showed good long-term clinical results. About half of the patients showed a bony spur at the distal radioulnar joint (DRUJ), but the clinical results did not significantly correlate with presence of bony spurs. Radiological parameters wre not related to the presence of bony spurs. (Group B) Twenty-four of the 66 patients investigated prospectively underwent an ulnar shortening osteotomy, with all showing good clinical results at 18 months postoperatively. Conclusions Ulnar shortening osteotomy can change the load of the ulnar side of the wrist and appears useful for ulnar-sided wrist pain in the presence of ulnar impaction. Level of evidence IV

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“…4 -6 These degenerative changes are often asymptomatic, but their radiographic presence may falsely lead some to unnecessary surgery. 2 In an effort to improve the diagnostic value of the physical examination and reduce the dependence on ancillary studies, we used the principle of synergism to establish the absence or presence of ECU tendonitis, a common cause of ulnar-sided wrist pain. The classic provocative maneuver for ECU tendonitis, 1 active resisted extension and ulnar deviation of the wrist, inadequately differentiates intra-articular from extra-articular pathology because the maneuver simultaneously stresses both groups of anatomic structures.…”

Section: Discussionmentioning

confidence: 99%

“…The close proximity of potentially painful pathoanatomy and the possibility of coexistent injuries can render physical examination maneuvers ambiguous, making it difficult to discern between intra-articular and extra-articular pathology. Maintaining the wrist in extension and ulnar deviation against resistance, a maneuver classically described for the evaluation of extensor carpi ulnaris (ECU) tendonitis, 1 has the disadvantage of (1) simultaneously loading the lunotriquetral ligament and the triangular fibrocartilage complex (TFCC), (2) compressing the distal ulna against the carpus, and (3) requiring the examiner to load the hand in proximity to the painful area. In the clinical setting of chronic dorsal ulnar-sided wrist pain, the re-creation of pain with the traditional ECU tendonitis test can occur with injury to any or all of the ulnocarpal structures, limiting its diagnostic accuracy.…”

mentioning

confidence: 99%