Mirza Ather, Mirza Justin B, Zappia Luke C, Thomas Terence L, Song Junho
North Shore Surgi-Center, Smithtown, New York.
Mirza Orthopedics, Smithtown, New York.
J Wrist Surg. 2024 Jul 5;14(5):406-411. doi: 10.1055/s-0044-1787751. eCollection 2025 Oct.
A retrospective analysis was performed to compare the clinical outcomes and complications of patients who underwent triangular fibrocartilage complex (TFCC) debridement based on gripping posteroanterior (PA) view ulnar variance measures.
Patients in Group A ( = 17) demonstrated ulnar variance measures <1.0 mm on the standard PA view and ≥1.0 mm on the gripping PA view. Patients in Group B ( = 13) maintained ulnar variance measures <1.0 mm on standard and gripping PA views. Clinical outcome measures included return to work, visual analog scale (VAS) scores, and range of motion. Complications included persistent pain, postoperative injections, and indication for revision surgery. Qualitative and quantitative measures were analyzed using Fisher exact tests and Student's -tests, respectively.
Significantly more patients in Group A (7/17) did not return to work compared with Group B (1/13) ( < 0.05). Mean VAS scores decreased from 7.0 to 5.3 in Group A and from 6.8 to 2.0 in Group B. Group A reported lower flexion-extension and pronation-supination arcs compared with Group B (110 vs. 130 degrees and 161 vs. 174 degrees) ( < 0.05). Significantly more patients in Group A (10/17) reported persistent pain at ≥3 months postoperatively compared with Group B (2/13) < 0.05). Seven cases were indicated for revision surgery in Group A, while no cases were indicated in Group B ( < 0.05).
Patients in Group A reported inferior clinical outcomes compared with Group B based on pain, range of motion, and indication for revision surgery. Dynamic ulnar variance may play a role in the clinical outcomes of patients treated with TFCC debridement.
Level IV.
TYPE OF STUDY/LEVEL OF EVIDENCE: Retrospective Comparative Study/Level IV.
进行一项回顾性分析,以比较根据握持后前位(PA)位尺骨变异测量结果接受三角纤维软骨复合体(TFCC)清创术的患者的临床结局和并发症。
A组(n = 17)患者在标准PA位上尺骨变异测量值<1.0 mm,在握持PA位上≥1.0 mm。B组(n = 13)患者在标准PA位和握持PA位上尺骨变异测量值均<1.0 mm。临床结局指标包括重返工作、视觉模拟量表(VAS)评分和活动范围。并发症包括持续疼痛、术后注射以及翻修手术指征。分别使用Fisher精确检验和学生t检验对定性和定量指标进行分析。
与B组(1/13)相比,A组(7/17)中未重返工作的患者明显更多(P<0.05)。A组的平均VAS评分从7.0降至5.3,B组从6.8降至2.0。与B组相比,A组报告的屈伸和旋前 - 旋后弧度更低(分别为110°对130°和161°对174°)(P<0.05)。与B组(2/13)相比,A组(10/17)中术后≥3个月报告持续疼痛的患者明显更多(P<0.05)。A组有7例患者需要进行翻修手术,而B组无病例需要(P<0.05)。
基于疼痛、活动范围和翻修手术指征,A组患者的临床结局比B组差。动态尺骨变异可能在接受TFCC清创术患者的临床结局中起作用。
IV级。
研究类型/证据级别:回顾性比较研究/IV级。