Effect of ulnar positive variance on outcomes after arthroscopic transosseous repair of palmer 1B TFCC foveal tears.

Abstract

To determine whether ulnar positive variance (UPV) and relative ulnar positive variance (RUPV) affect clinical outcomes following arthroscopic transosseous repair of triangular fibrocartilage complex (TFCC) foveal tears. This retrospective comparative study included patients who underwent arthroscopic transosseous repair for isolated Palmer type 1B TFCC foveal tears between April 2021 and June 2024, with a minimum follow-up of one year. Patients with concomitant fractures or those undergoing concurrent ulnar shortening osteotomy were excluded. Ulnar variance (UV) was measured on posteroanterior wrist radiographs, and relative UV was defined as the side-to-side difference in UV between the operated and contralateral wrists. Outcomes included the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, Visual Analogue Scale (VAS) pain score, wrist range of motion, and grip strength. A total of 36 patients were included, with a mean follow-up of 14.8 months (range, 12-39). Patients were stratified into non-UPV (n = 18) and UPV (n = 18) groups, and into non-RUPV (n = 14) and RUPV (n = 22) groups. There were no significant differences in baseline characteristics between groups except for age. No significant differences were observed in postoperative outcomes between the non-UPV and UPV groups, nor between the non-RUPV and RUPV groups. UPV and RUPV did not adversely affect clinical outcomes after arthroscopic transosseous TFCC foveal repair. These findings suggest that ulnar positive variance alone may not be sufficient evidence to justify the routine addition of ulnar shortening osteotomy during arthroscopic transosseous TFCC foveal repair in patients with a TFCC foveal tear. Level III, retrospective comparative study.