MRI Findings in Patients Undergoing Triangular Fibrocartilage Complex Repairs Versus Patients Without Ulnar-Sided Wrist Pain.

Abstract

<b>Background:</b> The clinical picture of ulnar-sided wrist pain is oftentimes confusing because various pathologies may be coexistent. In this study, we aimed: (1) to compare the prevalence of potential causes of ulnar-sided wrist pain on magnetic resonance imaging (MRI) in patients who underwent triangular fibrocartilage complex (TFCC) repair and control subjects: and (2) to evaluate whether inferior clinical results were associated with specific patient characteristics or other potential causes of ulnar-sided wrist pain. <b>Methods:</b> We included 67 patients who underwent a TFCC repair and 67 control subjects. The MRI scans were examined for sources of ulnar-sided wrist pain. After TFCC repair, 42 patients (63%) completed surveys, including Quick Disabilities of the Arm, Shoulder and Hand and pain scores. Bivariate analysis was performed to compare our groups and to identify factors associated with our outcomes. <b>Results:</b> We found significantly higher rates of distal radioulnar joint (DRUJ) arthritis (<i>P</i> = .033), extensor carpi ulnaris (ECU) pathology (<i>P</i> = .028), and ulnar styloid fractures (<i>P</i> = .028) in patients with TFCC repairs. With increasing age, increasing pathology in the pisotriquetral joint (<i>P</i> = .040), more ulnocarpal abutment (<i>P</i> = .0081), and more degenerative tears (<i>P</i> < .001) were seen in both groups. No demographic characteristics or MRI findings were significantly associated with our outcomes. <b>Conclusions:</b> We observed higher rates of DRUJ arthritis and ECU pathology in patients with TFCC tears undergoing repair compared with age- and sex-matched controls. This may be due to damage to the TFCC itself altering relationships of the DRUJ and the ECU subsheath, or it may reflect various pathologies that cause ulnar-sided wrist pain and drive patients toward surgery.