Incidence of dorsal radiocarpal ligament tears in the presence of other intercarpal derangements.

PURPOSE

The aim of this study was to examine the incidence of dorsal radiocarpal ligament (DRCL) tears in patients who underwent wrist arthroscopy for chronic pain.

METHODS

A chart review was performed of 64 patients who underwent diagnostic wrist arthroscopy for wrist pain. Interosseous ligament instability/tears were graded according to the Geissler classification. Tears of the triangular fibrocartilage complex (TFCC) and other intracarpal pathology were documented. Any DRCL tears were noted.

RESULTS

The average duration of wrist pain before arthroscopy was 20 months. There were 35 of 64 patients with DRCL tears. The average duration of wrist pain before treatment was 20 months (range, 4 to 60 months). There were 5 patients who had an isolated DRCL tear. Thirteen patients in this series had a scapholunate interosseous ligament (SLIL) derangement; 7 of 13 also had a DRCL tear. Seven patients had a lunotriquetral interosseous ligament (LTIL) derangement; 2 of 7 also had a DRCL tear. Two patients had a capitohamate ligament tear; 1 of these patients also had a DRCL tear. There were 7 patients with a solitary TFCC tear; 6 of 7 were in association with a DRCL tear. One patient had a chronic ulnar styloid nonunion and a DRCL tear. Two or more lesions were present in 23 patients; DRCL tears were present in 12 of 23 patients. Three patients had generalized arthrofibrosis; 1 had a volar ganglion and 2 had a normal examination. None of these were associated with DRCL tears.

CONCLUSIONS

DRCL tears are commonly seen with injuries to the SLIL, the LTIL, and the TFCC. Isolated DRCL tears should be treated with an arthroscopic repair. DRCL repairs in the presence of other intracarpal pathologies requires further study.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.