Do Ligamentous Tears Heal After Anatomically Reduced Distal Radius Fracture?

• Published in: Hand (New York, N.Y.) N.Y.), 2016-09, Vol.11 (1_suppl), p.45S-45S
• Main Authors: Fok, Margaret Woon Man, Fang, Christian Xinshuo, Lau, Tak Wing, Fung, Boris Kwok Keung, Leung, Frankie Ka Li
• Format: Article
• Language: English
• ISSN: 1558-9447; 1558-9455
• DOI: 10.1177/1558944716660555br

Objectives: Distal radius fracture was associated with a high incidence of ligamentous injury, including triangular fibrocartilage complex (TFCC) tear, scapholunate ligament (SL) tear, and lunotriquetral (LT) tear. This study aims to evaluate the status of these ligaments after the healing of distal radius fractures with plate fixation. Materials and Methods: Patients who were elected for the removal of plate after the healing of their distal radius were recruited for the study from August 2014 to January 2016. Concomitant wrist arthroscopy was performed to assess the status of the TFCC, SL, and LT. Results: In total, 34 patients with an average age of 53 years with healed distal radius fractures were recruited for the study. Twelve patients had extra-articular distal radius fractures; 15 patients had preoperative symptoms, including ulnar wrist pain; and 24 were noted to have distal radial ulnar joint (DRUJ) instability on examinations. The findings of wrist arthroscopies revealed 25 complete TFCC tears and 9 incomplete tears, showing signs of healing. Four patients had combined TFCC tears. All patients with symptoms and signs had TFCC tears, while the 9 patients with intact TFCC tear had neither symptoms nor signs. Sixty-seven percent of the patients had TFCC tears arisen from the sigmoid notch, and 29% had fovea tears. There was no correlation between ulnar wrist pain and the location of the TFCC tears, and there was no correlation between TFCC tear and the presence of ulnar styloid fractures. There were 26 SL tears and 15 LT tears. One patient with LT tear suffered from volar intercalated segment instability (VISI). None of the patients with SL and LT tears suffered from clinical signs and symptoms. No significant correlation was found between the SL and LT tears and the TFCC tears. Conclusion: A high incidence of TFCC, SL, and LT tears was noted after the union of anatomically reduced distal radius fractures. While TFCC tears may give rise to clinical signs and symptoms in terms of DRUJ instability, patients with SL and LT tears are relatively asymptomatic.