Triangular Fibrocartilage Complex Repair and Ulna Variance: A Systematic Review

Abstract

Background: This purpose of the study was to conduct a systematic review of available literature regarding the association between ulnar variance and outcomes after repair of peripheral traumatic tears of the triangular fibrocartilage complex (TFCC). Methods: A systematic literature search of the medical literature about peripheral tears of the TFCC was performed. We selected seven studies comparing clinical outcome and ulnar variance in patients with peripheral TFCC tears. We evaluated quality of the articles using both the Structured Effectiveness Quality Evaluation Scale (SEQES) and Sackett’s Level of Evidence (LOE). The outcomes were objective or self-assessment scoring systems for the function of the hand, wrist, or upper extremity. Results: Seven articles were evaluated. The SEQES scores varied from 19 to 28, with a mean of 23. Five studies reported no association between ulnar variance and clinical outcome, and 2 studies reported an association. The studies reporting no association either excluded or did not mention the cases of unstable distal radioulnar joint (DRUJ). Conclusions: This systematic review did not demonstrate strong evidence regarding the association between ulnar variance and outcomes after TFCC repair. As most of the studies did not distinguish between capsular and foveal tears which can affect DRUJ stability, further studies looking at this point are necessary to determine whether ulnar shortening osteotomy has an added value for better outcomes after TFCC repair.