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Ulnocarpal Arthroscopy and Distal Radioulnar Arthroscopy

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Arthroscopy and Endoscopy of the Hand, Wrist and Elbow

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Abstract

The triangular fibrocartilage complex (TFCC) is the major stabilizer of the distal radioulnar joint. TFCC disorders may have traumatic or degenerative etiology. TFCC is most often lacerated at its ulnar periphery. According to the magnitude and direction of the traumatic force, the TFCC may rupture in a variable manner, and the ulnar styloid may also fracture, producing different subtypes of type 1B tears. Treatment options are variable, depending on the tear’s features. Atzei introduced in 2011 a novel treatment-oriented classification subdividing 1B-type lesions into five different classes according to the finding of special radiocarpal arthroscopic tests and distal radioulnar joint arthroscopy. In this chapter, the all-inside arthroscopic repair technique for Atzei class 2 and 3 TFCC foveal lesions is described.

In chronic irreparable TFCC tears with clinical DRUJ instability in which the articular cartilage is in good condition, ligament reconstruction with tendon graft is the treatment of choice. It is also the preferred treatment in cases of previous failed repair surgeries in patients with clinical DRUJ instability. In this chapter, the All-Arthroscopic technique for TFCC ligamentoplasty based on the anatomical insertions of the triangular fibrocartilage in the ulnar fovea and in the dorsal and volar corners of the sigmoid notch is also described.

Ulnocarpal impaction syndrome is a common cause of pain and functional loss. The treatment is based on decompressing the ulnar head by shortening osteotomies or partial resection. Wafer procedure reduces ulnocarpal pressure without implants. In this chapter, arthroscopic wafer technique is described.

The corresponding author of Sect. 5.1 is Andrea Atzei, E-mail: andreatzei@gmail.com

The corresponding author of Sect. 5.2 is Vicente Carratalá Baixauli, E-mail: vtecabaix@gmail.com

The corresponding author of Sect. 5.3 is Pedro J. Delgado, E-mail: pdelgado@mail.hmhospitales.com

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References

  1. Linscheid RL. Biomechanics of the distal radioulnar joint. Clin Orthop. 1992;275:46–55.

    Google Scholar 

  2. Tolat AR, Stanley JK, Trail IA. Different types of sigmoid notch variations: the flat face comprises 42% of sigmoid notch types. A cadaveric study of the anatomy and stability of the distal radioulnar joint in the coronal and transverse planes. J Hand Surg Br. 1996;21(5):592.

    Article  Google Scholar 

  3. Ekenstam F, Hagert CG. Anatomical studies on the geometry and stability of the distal radio ulnar joint. Scand J Plast Reconstr Surg. 1985;19(1):17e25.

    Google Scholar 

  4. Hagert CG. Distal radius fracture and the distal radioulnar joint—anatomical considerations. Handchir Mikrochir Plast. 1994;26:22–6.

    CAS  Google Scholar 

  5. Haugstvedt JR, Berger RA, Nakamura T, Neale P, Berglund L, An KN. Relative contributions of the ulnar attachments of the triangular fibrocartilage complex to the dynamic stability of the distal radioulnar joint. J Hand Surg Am. 2006;31A:445–51.

    Article  Google Scholar 

  6. Palmer AK, Werner FW. The triangular fibrocartilage complex of the wrist—anatomy and function. J Hand Surg Am. 1981;6:153–62.

    Article  CAS  PubMed  Google Scholar 

  7. Nakamura T, Yabe Y, Horiuchi Y. Functional anatomy of the triangular fibrocartilage complex. Hand Surg. 1996;21:581–6.

    Article  CAS  Google Scholar 

  8. Nakamura T, Makita A. The proximal ligamentous component of the triangular fibrocartilage complex: functional anatomy and three-dimensional changes in length of the radioulnar ligament during pronation-supination. J Hand Surg Br. 2000;25B:479–86.

    Google Scholar 

  9. Adams BD, Holley KA. Strains in the articular disk of the triangular fibrocartilage complex: a biomechanical study. J Hand Surg Am. 1993;18:919–25.

    Article  CAS  PubMed  Google Scholar 

  10. Benjamin M, Evans EJ, Pemberton DJ. Histological studies on the triangular fibrocartilage complex of the wrist. J Anat. 1990;172:59–67.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Kauer JMG. The distal radioulnar joint: anatomic and functional considerations. Clin Orthop Relat R. 1992;275:37–45.

    Google Scholar 

  12. Kleinman WB. Stability of the distal radioulnar joint: biomechanics, pathophysiology, physical diagnosis and restoration of function. What we have learned in 25 years. J Hand Surg Am. 2007;32:1087–106.

    Article  Google Scholar 

  13. Moritomo H, Murase T, Arimitsu S, Oka K. Change in the length of the ulnocarpal ligaments during radiocarpal motion: possible impact on triangular fibrocartilage complex foveal tears. J Hand Surg Am. 2008;33:1278–86.

    Article  PubMed  Google Scholar 

  14. Dy CJ, Ouellette EA, Makowski AL, Milne E, Latta LL. Peripheral triangular fibrocartilage complex tears cause ulnocarpal instability: a biomechanical pilot study. Clin Orthop Relat Res. 2012 Oct;470(10):2771–5.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Atzei A, Luchetti R. Foveal TFCC tear classification and treatment. Hand Clin. 2011;27(3):263–72.

    Article  PubMed  Google Scholar 

  16. Palmer AK. Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am. 1989;14:594–606.

    Article  CAS  PubMed  Google Scholar 

  17. Atzei A, Luchetti R, Braidotti F. Arthroscopic foveal repair of the triangular fibrocartilage complex. J Wrist Surg. 2015;4(1):22–30.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tay SC, Tomita K, Berger RA. The “ulnar fovea sign” for defining ulnar wrist pain: an analysis of sensitivity and specificity. J Hand Surg Am. 2007;32(4):438–44.

    Article  PubMed  Google Scholar 

  19. Moriya T, Aoki M, Iba K, et al. Effect of triangular ligament tears on distal radioulnar joint instability and evaluation of three clinical tests: a biomechanical study. J Hand Surg Eur Vol. 2009;34:219–23.

    Article  CAS  PubMed  Google Scholar 

  20. Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg Am. 2000;25:464–8.

    Article  CAS  PubMed  Google Scholar 

  21. May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg Am. 2002;27:965–71.

    Article  PubMed  Google Scholar 

  22. Richards RS, Bennett JD, Roth JH, et al. Arthroscopic diagnosis of intraarticular soft tissue injuries associated with distal radial fractures. J Hand Surg Am. 1997;22:772–6.

    Article  CAS  PubMed  Google Scholar 

  23. Lindau T. Treatment of injuries to the ulnar side of the wrist occurring with distal radial fractures. Hand Clin. 2005;21:417–25.

    Article  PubMed  Google Scholar 

  24. Fulcher S, Poehling G. The role of operative arthroscopy for the diagnosis and treatment of lesions about the distal ulna. Hand Clin. 1998;14:285–96.

    Article  CAS  PubMed  Google Scholar 

  25. Pederzini L, Luchetti R, Soragni O, et al. Evaluation of the triangular fibrocartilage complex tears by arthroscopy, arthrography, and magnetic resonance imaging. Arthroscopy. 1992;8:191–7.

    Article  CAS  PubMed  Google Scholar 

  26. Hermansdorfer JD, Kleinman WB. Management of chronic peripheral tears of the triangular fibrocartilage complex. J Hand Surg Am. 1991;16:340–6.

    Article  CAS  PubMed  Google Scholar 

  27. Atzei A, Rizzo A, Luchetti R, Fairplay T. Arthroscopic foveal repair of triangular fibrocartilage complex peripheral lesion with distal radioulnar joint instability. Tech Hand Up Extrem Surg. 2008;12(4):226–35.

    Article  PubMed  Google Scholar 

  28. Haugstvedt JR, Husby T. Results of repair of peripheral tears in the triangular fibrocartilage complex using an arthroscopic suture technique. Scand J Plast Reconstr Surg Hand Surg. 1999;33:439–47.

    Article  CAS  PubMed  Google Scholar 

  29. Kim SH, Ha KI. The SMC knot–a new slipknot with locking mechanism. Arthroscopy. 2000;16:563–5.

    Article  CAS  PubMed  Google Scholar 

  30. Atzei A, Luchetti R, Sgarbossa A, Carità E, Llusà M. Setup, portals and normal exploration in wrist arthroscopy. Chir de la Main. 2006;25(Suppl):S131–44.

    Article  Google Scholar 

  31. del Piñal F, García-Bernal FJ, Pisani D, Regalado J, Ayala H, Studer A. Dry arthroscopy of the wrist: surgical technique. J Hand Surg Am. 2007;32:119–23.

    Article  PubMed  Google Scholar 

  32. Nakamura T, Makita A. The proximal ligamentous component of the triangular fibrocartilage complex. J Hand Surg Br. 2000;25:479–86. https://doi.org/10.1054/jhsb.1999.0329.

    Article  CAS  PubMed  Google Scholar 

  33. Breen T, Jupiter J. Extensor carpi ulnaris and flexor carpi ulnaris tenodesis of the unstable distal ulna. J Hand Surg Am. 1989;14:612–7.

    Article  CAS  PubMed  Google Scholar 

  34. Eliason EL. An operation for recurrent inferior radioulnar dislocation. Ann Surg. 1932;96:27–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Hui F, Linscheid R. Ulnotriquetral augmentation tenodesis: a reconstructive procedure for dorsal subluxation of the distal radioulnar joint. J Hand Surg Am. 1982;7:230–6.

    Article  CAS  PubMed  Google Scholar 

  36. Johnson R, Shrewsbury M. The pronator quadratus in motions and in stabilization of the radius and ulna at the distal radioulnar joint. J Hand Surg Am. 1976;1:205–9.

    Article  CAS  PubMed  Google Scholar 

  37. Mansat M, Mansat C, Martinez C. L’articulation radio-ulnare inférieur. Pathologie traumatique. Le poignet. 1983;1:187–95.

    Google Scholar 

  38. Adams BD, Berger RA. An anatomic reconstruction of the distal radioulnar ligaments for posttraumatic distal radioulnar joint instability. J Hand Surg Am. 2002;27:243–51.

    Article  PubMed  Google Scholar 

  39. Luchetti R, Atzei A. Arthroscopic assisted tendon reconstruction for triangular fibrocartilage complex irreparable tears. J Hand Surg Eur Vol. 2017;42:346–51.

    Article  CAS  PubMed  Google Scholar 

  40. Mak MC, Ho P. Arthroscopic-assisted triangular fibrocartilage complex reconstruction. Hand Clin. 2017;33:625–37. https://doi.org/10.1016/j.hcl.2017.07.014.

    Article  Google Scholar 

  41. Carratalá Baixauli V, Lucas García FJ, Martínez Andrade C, Carratalá Baixauli R, Guisasola Lerma E, Corella MF. All-arthroscopic triangular fibrocartilage complex ligamentoplasty for chronic DRUJ instability. Tech Hand Up Extrem Surg. 2019;23:44–51.

    Article  PubMed  Google Scholar 

  42. Park J, Ahn K, Chang A, Kwon Y, Choi I, Park J. Changes in the morphology of the triangular fibrocartilage complex (TFCC) on magnetic resonance arthrography related to disruption of ulnar foveal attachment. Skelet Radiol. 2020;49:249–56. https://doi.org/10.1007/s00256-019-03278-x.

    Article  Google Scholar 

  43. Mutimer J, Green J, Field J. Comparison of MRI and wrist arthroscopy for assessment of wrist cartilage. J Hand Surg Eur Vol. 2008;33:380–2. https://doi.org/10.1177/1753193408090395.

    Article  CAS  PubMed  Google Scholar 

  44. Ekman EF, Poehling GG. Principles of arthroscopy and wrist arthroscopy equipment. Hand Clin. 1994;10:557–66.

    Article  CAS  PubMed  Google Scholar 

  45. Geissler WB, Freeland AE, Weiss APC, et al. Techniques of wrist arthroscopy. J Bone Joint Surg. 1999;81-A:1184–97.

    Article  Google Scholar 

  46. Slutsky DJ. Wrist arthroscopy portals. In: Slutsky DJ, Nagel DJ, editors. Techniques in hand and wrist arthroscopy. Philadelphia: Elsevier; 2007. p. 2–17.

    Chapter  Google Scholar 

  47. Carratalá Baixauli V, Lucas García F, González Jofré C, Carratalá Baixauli R, Sánchez AE. Técnica de reinserción foveal artroscópica sin nudos del fibrocartílago triangular con visión directa de la articulación radiocubital distal. Rev Iberoam Cir Mano. 2016;44:39–46. https://doi.org/10.1016/j.ricma.2016.02.002.

    Article  Google Scholar 

  48. Lucas FJ, Carratalá V, Miranda I, Martinez C. The volar distal radioulnar portal in wrist arthroscopy: an anatomical study. J Wrist Surg. 2020;10(2):176–82.

    PubMed  PubMed Central  Google Scholar 

  49. Palmer AK, Werner FW. Biomechanics of the distal radioulnar joint. Clin Orthop Relat Res. 1984;188:26–35.

    Google Scholar 

  50. Hara T, Horii E, An KN, et al. Force distribution across wrist joint: application of pressure-sensitive conductive rubber. J Hand Surg Am. 1992;17(2):339–47.

    Article  CAS  PubMed  Google Scholar 

  51. Tomaino MM. Ulnar impaction syndrome in the ulnar negative and neutral wrist. Diagnosis and pathoanatomy. J Hand Surg Br. 1998;23(6):754–7.

    Article  CAS  PubMed  Google Scholar 

  52. Palmer AK, Glisson RR, Werner FW. Relationship between ulnar variance and triangular fibrocartilage complex thickness. J Hand Surg Am. 1984;9(5):681–2.

    Article  CAS  PubMed  Google Scholar 

  53. af Ekenstam FM, Palmer AK, Glisson RR. The load on the radius and ulna in different positions of the wrist and forearm. A cadaver study. Acta Orthop Scand. 1984;55(3):363–5.

    Article  CAS  PubMed  Google Scholar 

  54. Wright TW, Del Charco M, Wheeler D. Incidence of ligament lesions and associated degenerative changes in the elderly wrist. J Hand Surg Am. 1994;19:313–8.

    Article  CAS  PubMed  Google Scholar 

  55. Park JH, Jang WY, Kwak DH, Park JW. Lunate morphology as a risk factor of idiopathic ulnar impaction syndrome. JBJS. 2017;99-B:1508–14.

    CAS  Google Scholar 

  56. Pfaeffle HJ, Manson T, Fischer KJ. Axial loading alters ulnar variance and distal ulna load with forearm pronation. Pittsburgh Orthop J. 1999;10:101–2.

    Google Scholar 

  57. Orbay JL, Levaro-Pano F, Vernon LL, Cronin MH, Orbay JA, Tremols EJ. The parallelogram effect: the association between central band and positive ulnar variance. J Hand Surg Am. 2018;43:827–32.

    Article  PubMed  Google Scholar 

  58. Nakamura R, Horii E, Imaeda T, et al. The ulnocarpal stress test in the diagnosis of ulnar-sided wrist pain. J Hand Surg Br. 1997;22(6):719–23.

    Article  CAS  PubMed  Google Scholar 

  59. Regan DS, Linscheid RL, Dobins JH. Lunotriquetal sprains. J Hand Surg Am. 1984;9:502–14.

    Article  Google Scholar 

  60. Kleinman WB. Physical examination of the wrist: useful provocative maneuvers. J Hand Surg Am. 2015;40:1486–500.

    Article  PubMed  Google Scholar 

  61. Cerezal L, del Pinal F, Abascal F, et al. Imaging findings in ulnar-sided wrist impaction syndromes. Radiographics. 2002;22:105–21.

    Article  PubMed  Google Scholar 

  62. Imaeda T, Nakamura R, Shionoya K, Makino N. Ulnar impaction syndrome: MR imaging findings. Radiology. 1996;201:495–500.

    Article  CAS  PubMed  Google Scholar 

  63. McBeath R, Katolik LI, Shin EK. Ulnar shortening osteotomy for ulnar impaction syndrome. J Hand Surg Am. 2013 Feb;38(2):379–81.

    Article  PubMed  Google Scholar 

  64. Stockton DJ, Pelletier ME, Pike JM. Operative treatment of ulnar impaction syndrome: a systematic review. J Hand Surg Eur. 2015;40E(5):470–6.

    Article  Google Scholar 

  65. Slade JF III, Guillon TJ. Osteochondral shortening osteotomy for the treatment of ulnar impaction syndrome: a new technique. Tech Hand Upper Extrem Surg. 2007;11(1):74–82.

    Article  Google Scholar 

  66. Barry JA, Macksoud WS. Cartilage-retaining wafer resection osteotomy of the distal ulna. Clin Orthop Relat Res. 2008;466:396–401.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Nunez FA Jr, Barnwell J, Li Z, Nunez FA Sr. Metaphyseal ulnar shortening osteotomy for the treatment of ulnocarpal abutment syndrome using distal ulna hook plate: case series. J Hand Surg Am. 2012;37:1574–9.

    Article  PubMed  Google Scholar 

  68. Yin HW, Qiu Y-Q, Shen Y-D, Xu J-G, Gu Y-D, Xu W-D. Arthroscopic distal metaphyseal ulnar shortening osteotomy for ulnar impaction syndrome: a different technique. J Hand Surg Am. 2013;38:2257–62.

    Article  PubMed  Google Scholar 

  69. Bernstein MA, et al. A comparison of combined arthroscopic triangular fibrocartilage complex debridement and arthroscopic wafer distal ulna resection versus arthroscopic triangular fibrocartilage complex debridement and ulnar shortening osteotomy for ulnocarpal abutment syndrome. Arthroscopy. 2004;20(4):392–401.

    Article  PubMed  Google Scholar 

  70. Milch H. Cuff resection of the ulna for malunited Colles’ fracture. J Bone Joint Surg Am. 1941;23(2):311–3.

    Google Scholar 

  71. Sachar K. Ulnar-sided wrist pain: evaluation and treatment of TFCC tears, ulnocarpal impaction syndrome and lunotriquetral ligament tears. J Hand Surg. 2012;37(7):1489−1500.

    Google Scholar 

  72. Nishiwaki M, Nakamura T, Nagura T, Toyama Y, Ikegami H. Ulnar-shortening effect on distal radioulnar joint pressure: a biomechanical study. J Hand Surg Am. 2008;33(2):198–205.

    Article  PubMed  Google Scholar 

  73. Arimitsu S, Moritomo H, Kitamura T, Berglund LJ, Zhao KD, An K-N, Rizzo M. The stabilizing effect of the distal interosseous membrane on the distal radioulnar joint in an ulnar shortening procedure: a biomechanical study. J Bone Joint Surg Am. 2011;93:2022–30.

    Article  PubMed  Google Scholar 

  74. Hammert WC, Williams RB, Greenberg JA. Distal metaphyseal ulnar-shortening osteotomy: surgical technique. J Hand Surg Am. 2012;37:1071–7.

    Article  PubMed  Google Scholar 

  75. Elgammal A, Rozée B. Outcomes of the ulnar shortening osteotomy using a dynamic compression plate on the ulnar surface of the ulna. J Wrist Surg. 2018;7:344–9.

    Article  PubMed  Google Scholar 

  76. Nishiwaki M, Nakamura T, Nakao Y, Nagura T, Toyama Y. Ulnar shortening effect on distal radioulnar joint stability: a biomechanical study. J Hand Surg Am. 2005;30:719–26.

    Article  PubMed  Google Scholar 

  77. Isa AD, Mcgregor ME, Padmore CE, Langohr DG, Johnson JA, King GJW, Suh N. An in vitro study to determine the effect of ulnar shortening on distal forearm loading during wrist and forearm motion: implications in the treatment of ulnocarpal impaction. J Hand Surg Am. 2019;44:669–79.

    Article  PubMed  Google Scholar 

  78. Koh KH, Lee HL, Chang YS, Park MJ. Arthroscopy during ulnar shortening for idiopathic ulnar impaction syndrome. Orthopedics. 2013;36:e1495–500.

    Article  PubMed  Google Scholar 

  79. Nishizuka T, Tatebe M, Hirata H, Shinohara T, Yamamoto M, Iwatsuki K. Simple debridement has little useful value on the clinical course of recalcitrant ulnar wrist pain. Bone Joint J. 2013;95B:1687–96.

    Article  Google Scholar 

  80. Tolat AR, Stanley JK, Trail IA. A cadaveric study of the anatomy and stability of the distal radioul- nar joint in the coronal and transverse planes. J Hand Surg Br. 1996;21:587–94.

    Article  CAS  PubMed  Google Scholar 

  81. Daneshvar P, Willing R, Pahuta M, Grewal R, King GJW. Osseous anatomy of the distal radioulnar joint: an assessment using 3-dimensional modeling and clinical implications. J Hand Surg Am. 2016;41:1071–9.

    Article  PubMed  Google Scholar 

  82. Kim J, Cho J, Lee YH, Oh S, Gong HS, Baek GH. Distal radioulnar joint configurations in three-dimensional computed tomography in patients with idiopathic ulnar impaction syndrome. J Hand Surg Eur Vol. 2019;44:488–95.

    Article  PubMed  Google Scholar 

  83. de Runz A, Pauchard N, Sorin T, Dap F, Dautel G. Ulna-shortening osteotomy: outcome and repercussion of the distal radioulnar joint osteoarthritis. Plast Reconstr Surg. 2016;137:175–84.

    Article  CAS  PubMed  Google Scholar 

  84. Iwasaki N, Ishikawa J, Kato H, Minami M, Minami A. Factors affecting results of ulnar shortening for ulnar impaction syndrome. Clin Orthop Relat Res. 2007;465:215–9.

    Article  PubMed  Google Scholar 

  85. Iniesta A, Bonev B, Curvale C, Legré R, Gay A. Outcomes of ulnar shortening osteotomy using a new compression plate. Hand Surg Rehabil. 2020;39:19–22.

    Article  CAS  PubMed  Google Scholar 

  86. Sunil TM, Wolff TW, Scheker LR, et al. A comparative study of ulnar-shortening osteotomy by the freehand technique versus the Rayhack technique. J Hand Surg Am. 2006;31:252–7.

    Article  CAS  PubMed  Google Scholar 

  87. Chen F, Osterman AL, Mahony K. Smoking and bony union after ulna-shortening osteotomy. Am J Orthop (Belle Mead NJ). 2001;30(6):486–9.

    CAS  Google Scholar 

  88. Ahsan ZS, Song Y, Yao J. Outcomes of ulnar shortening osteotomy fixed with a dynamic compression system. J Hand Surg Am. 2013;38:1520–3.

    Article  PubMed  Google Scholar 

  89. Moermans A, Degreef I, De Smet L. Ulnar shortening osteotomy for ulnar ideopathic impaction syndrome. Scand J Plast Reconstr Surg Hand Surg. 2007;41:310–4.

    Article  PubMed  Google Scholar 

  90. Nuñez FA Jr, Marquez-Lara A, Newman EA, Li Z, Nuñez FA. Determinants of pain and predictors of pain relief after ulnar shortening osteotomy for ulnar impaction syndrome. J Wrist Surg. 2019;8:395–402.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Seo JB, Kim JP, Yi HS, Park KH. The outcomes of arthroscopic repair versus debridement for chronic unstable triangular fibrocartilage complex tears in patients undergoing ulnar-shortening osteo- tomy. J Hand Surg Am. 2016;41(05):615–23.

    Article  PubMed  Google Scholar 

  92. Feldon P, Terrono AL, Belsky MR. Wafer distal ulna resection for triangular fibrocartilage tears and/or ulna impaction syndrome. J Hand Surg. 1992;17A:731–7.

    Article  Google Scholar 

  93. Buterbaugh G. Ulnar impaction syndrome: treatment by arthroscopic removal of the distal ulna. Tech Orthop. 1992;7:66–71.

    Article  Google Scholar 

  94. Palmer AK. Triangular fibrocartilage disorders: injury patterns and treatment. Arthroscopy. 1990;6:125–32.

    Article  CAS  PubMed  Google Scholar 

  95. Markolf KL, Tejwani SG, Benhaim P. Effects of wafer resection and hemiresetion from the distal ulna on load-sharing at the wrist: a cadaveric study. J Hand Surg Am. 2005;30(2):351–8.

    Article  PubMed  Google Scholar 

  96. Vandenberghe L, Degreef I, Didden K, Moermans A, Koorneef P, De Smet L. Ulnar shortening or arthroscopic wafer resection for ulnar impaction syndrome. Acta Orthop Belg. 2012;78:323–6.

    PubMed  Google Scholar 

  97. Bernstein MA, Nagle DJ, Martinez A, Stogin JM Jr, Wiedrich TA. A comparison of combined arthroscopic triangular fibrocartilage complex debridement and arthroscopic wafer distal ulna resection versus arthroscopic triangular fibrocartilage complex debridement and ulnar shortening osteotomy for ulnocarpal abutment syndrome. Arthroscopy. 2004;20:392–401.

    Article  PubMed  Google Scholar 

  98. Tomaino MM. Editorial Commentary: Wrist ulnar impaction syndrome: when I use the wafer procedure and when I do not. Arthroscopy. 2018;34:431–2.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Pro-Mano, Hand Surgery and Rehabilitation, Treviso, Italy

    Andrea Atzei

  2. Rimini Hand and Upper Limb Surgery and Rehabilitation Center, Rimini, Italy

    Riccardo Luchetti

  3. Hand and Microsurgery Unit, Jewish Hospital of Rome, Rome, Italy

    Lucian Lior Marcovici

  4. Hand and Upper Limb Surgery Unit, Hospital Quirónsalud Valencia, Valencia, Spain

    Vicente Carratalá Baixauli, Francisco J. Lucas García & Cristóbal Martínez Andrade

  5. Traumaunit Teknon Clinic, Barcelona, Spain

    Cristóbal Martínez Andrade

  6. Department of Orthopaedics, Hand and Microsurgery Unit, HM Montepríncipe Universitary Hospital, San Pablo CEU University, Madrid, Spain

    Pedro J. Delgado & Belén García-Medrano

  7. Department of Orthopaedics, Hand and Microsurgery Unit, HM Montepríncipe Universitary Hospital, Mutua Universal, Madrid, Spain

    Fernando Polo

  8. Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong, China

    Tun Hing Lui

  9. The Second Affiliated Hospital, Shenzhen University, Shenzhen, China

    Tun Hing Lui

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  1. Andrea Atzei
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  1. Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong, China

    Tun Hing Lui

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Atzei, A. et al. (2021). Ulnocarpal Arthroscopy and Distal Radioulnar Arthroscopy. In: Lui, T.H. (eds) Arthroscopy and Endoscopy of the Hand, Wrist and Elbow. Springer, Singapore. https://doi.org/10.1007/978-981-16-4142-8_5

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  • DOI: https://doi.org/10.1007/978-981-16-4142-8_5

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  • Print ISBN: 978-981-16-4141-1

  • Online ISBN: 978-981-16-4142-8

  • eBook Packages: MedicineMedicine (R0)

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