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UT Ligament Split Tears

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Wrist and Elbow Arthroscopy with Selected Open Procedures

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Abstract

The ulnar side of the wrist is comprised of a complex layering of soft tissue and bony anatomy that can make diagnosis and treatment of injuries in this area very challenging. However, having an intimate understanding of this anatomy allows one to utilize a combination of history, physical examination, imaging, and arthroscopy to diagnose the pathology and synthesize a treatment plan.

The most important examination maneuver to diagnose a split tear of the ulnotriquetral (UT) ligament is the ulnar fovea test. If the test is positive, the stability of the distal radioulnar joint (DRUJ) must be determined. If it is stable, a UT split tear versus a peripheral triangular fibrocartilage complex (TFCC) tear is the most likely diagnosis, but if it is not stable, a TFCC foveal avulsion is more likely.

Although imaging can be useful, diagnostic wrist arthroscopy remains the gold standard for diagnosis of UT ligament split tears.

Once identified, split tears can be repaired arthroscopically using horizontal mattress sutures through a mini-open technique. After repair, patients are placed on a specific UT ligament tear repair protocol and are followed closely.

UT split tear repair has shown promising clinical outcomes in relieving pain and improving wrist function while having a low complication rate.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Nicholas Munaretto & Sanjeev Kakar

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  1. Nicholas Munaretto
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  2. Sanjeev Kakar
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Correspondence to Sanjeev Kakar .

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Editors and Affiliations

  1. Division of Hand and Upper Extremity Surgery Section of Arthroscopic Surgery and Sports Medicine, Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson, MS, USA

    William B. Geissler

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Munaretto, N., Kakar, S. (2022). UT Ligament Split Tears. In: Geissler, W.B. (eds) Wrist and Elbow Arthroscopy with Selected Open Procedures. Springer, Cham. https://doi.org/10.1007/978-3-030-78881-0_8

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  • DOI: https://doi.org/10.1007/978-3-030-78881-0_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-78880-3

  • Online ISBN: 978-3-030-78881-0

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