Arthroscopic debridement of intercarpal ligament and triangular fibrocartilage complex tears

Tan SWJ, Ng SW, Tan SH, Teoh LC
Correspondence: Dr Tan Siau Woon Jacqueline, aceug@yahoo.com

ABSTRACT
Introduction Wrist arthroscopy has evolved since its inception to become an essential diagnostic and therapeutic tool for the management of various wrist disorders. Our study aimed to examine the outcomes of arthroscopic debridement in the treatment of scapholunate (SL), lunotriquetral (LT) and triangular fibrocartilage complex (TFCC) tears.
Methods We conducted a retrospective review of 68 consecutive wrist arthroscopies performed at our institution between January 2000 and July 2005. All the patients complained of wrist pain, which often interfered with their daily activities, work or sports. A standard arthroscopic technique was employed in all. Any intercarpal ligament or TFCC tears found were debrided.
Results There were 42 patients with TFCC tears, 58 with SL tears and 49 with LT tears. At a mean follow-up time of 16.6 months, 85.3% of the patients reported an improvement in symptoms and 27.9% had improved range of motion. Grip strength improved by 11.8%. All except two patients returned to their original activities. Outcome following arthroscopic debridement was determined using the Mayo Modified Wrist Score. Based on the postoperative wrist scores of 47 patients, 24 were rated excellent, 17 good, four fair and two poor. By comparing the pre- and postoperative wrist scores of 31 patients, we were able to demonstrate significant improvement in patients who underwent wrist arthroscopies.
Conclusion Our study demonstrated that there is a definite role for arthroscopic debridement in the management of SL, LT and TFCC tears.

Keywords: arthroscopic debridement, ligament, triangular fibrocartilage complex
Singapore Med J 2012; 53(3): 188–191