In our study, quantitative evaluations were performed using MRI to clarify the effect of ulnar shortening on triangular fibrocartilage (TFC) thickness attributable to disc regeneration of the TFC and TFC angle attributable to the suspension effect of ulnar shortening on the TFC. However, the effect of ulnar shortening osteotomy on the changes in shape of the TFCC is unclear. Ulnar shortening osteotomy often is indicated for treatment of injuries to the triangular fibrocartilage complex (TFCC). Yamanaka, Yoshiaki Nakamura, Toshiyasu Sato, Kazuki Toyama, Yoshiaki How does ulnar shortening osteotomy influence morphologic changes in the triangular fibrocartilage complex? Arthroscopic-assisted suture anchor reattachment of the TFCC in patients with traumatic TFCC foveal avulsion can prevent or reduce distal radioulnar joint instability and reduce pain even in chronic cases with positive UV. The Mayo wrist scores were excellent in 10 cases, good in 2, and fair in 3, and the mean score improved significantly from 64 points preoperatively to 84 points postoperatively (P =. The Disabilities of the Arm, Shoulder and Hand scores were 28.4 points preoperatively and 16.6 points postoperatively (P =. Grip power (compared with the uninvolved limb) was 79.3% preoperatively and 82.9% postoperatively (P =. In all cases the distal radioulnar joint instability disappeared postoperatively. The mean UV value based on preoperative simple radiographic findings was 1.7 ± 1.0 mm, and dorsal subluxation at the distal ulna improved from 2.9 ± 3.0 mm to 0.2 ± 0.9 mm (P =. On preoperative magnetic resonance imaging, TFCC foveal avulsion was observed in 13 of 15 cases. Radiographs obtained to assess ulnar variance (UV), ulnar-dorsal subluxation, and function of the wrist based on grip power Disabilities of the Arm, Shoulder and Hand score and Mayo wrist score were examined for all patients both preoperatively and postoperatively. All the patients underwent magnetic resonance imaging. The patients had TFCC foveal avulsion caused by sprains (n = 8), falls (n = 4), playing baseball (n = 2), and a motor vehicle accident (n = 1). The patients were followed up for a mean of 29 months. We retrospectively reviewed the results of 15 patients (11 men and 4 women mean age, 30.5 years) who underwent surgical procedures for the treatment of TFCC foveal avulsion at our hospital. Our aim was to evaluate the clinical results of patients treated by arthroscopically assisted reconstruction of foveal avulsion injury of the triangular fibrocartilage complex (TFCC) using a suture anchor. Kim, ByungSung Yoon, Hong-Kee Nho, Jae-Hwi Park, Kang Hee Park, Sung-Yong Yoon, Jun-Hee Song, Hyun Seok All rights reserved.Īrthroscopically assisted reconstruction of triangular fibrocartilage complex foveal avulsion in the ulnar variance-positive patient. Copyright © 2011 American Society for Surgery of the Hand. Young adolescent boys demonstrated a greater degree of negative ulnar variance compared with young adolescent girls. Open growth plates did not interfere with this assessment. Standard assessment techniques for ulnar variance are reliable in the adolescent population. Interrater reliability was excellent (Cronbach's alpha, 0.97-0.98). Correlations between raters were high (r(p) 0.87-0.97 in boys and 0.82-0.96 for girls). The greatest difference between any 2 raters was 1 mm exact agreement was obtained in 72 subjects.
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There was no significant difference between boys and girls in the older group. When subdivided by age and gender, the younger group (≤ 15 y of age) was significantly less negative for girls (boys, -0.8 mm and girls, -0.3 mm, p <.
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The mean variance was -0.7 mm for boys and -0.4 mm for girls there was no significant difference between the 2 groups overall. We also determined the interrater reliability. We determined mean variance and assessed for differences related to age and gender. There were 62 male and 76 female radiographs obtained in a standardized fashion for subjects aged 12 to 18 years. Four orthopedic surgeons measured 138 adolescent wrist radiographs for ulnar variance using a standard technique. The purpose of this study was to assess the reliability of a standard ulnar variance assessment in the adolescent population. The measurement technique for ulnar variance in the adolescent population has not been well established. Goldfarb, Charles A Strauss, Nicole L Wall, Lindley B Calfee, Ryan P Defining ulnar variance in the adolescent wrist: measurement technique and interobserver reliability.