Purpose: The goal of this study was to determine if arthroscopic repair of a dorsal radiocarpal
ligament (DRCL) tear is effective in ameliorating wrist pain. Type of Study: Retrospective study. Methods: A chart review was performed of 53 patients (56 wrists) who underwent wrist arthroscopy
with use of a volar radial portal. There were 21 patients with DRCL tears. Mean follow-up
was 16 months. Thirteen patients underwent arthroscopic DRCL repair and/or thermal
shrinkage (5 repairs, 6 repair plus shrinkage, and 2 shrinkage). Lunotriquetral tears
were treated with debridement and pinning. Triangular fibrocartilage (TFC) tears were
debrided or repaired. Scapholunate ligament tears/instability were treated with capsulodesis.
Results: The 4 patients who underwent repair of an isolated DRCL tear had excellent results
with no or mild pain. All returned to their previous occupation. Dorsal capsulodesis
was performed in 7 patients with 4 fair/poor results. Nine DRCL repairs/shrinkage
were in association with other procedures for ulnar-sided pathology with 6 fair/poor
results. Conclusions: Tears of the DRCL are more common than previously suspected. They are best seen through
a volar radial portal and are amenable to arthroscopic repair. DRCL tears appear to
be part of a spectrum of radial and ulnar-sided carpal instability as evidenced by
the frequent association with scapholunate ligament tears/instability or ulnar-sided
pathology. Isolated DRCL tears can be solely responsible for wrist pain. Good results
are obtained with arthroscopic repair of isolated DRCL tears. The presence of a DRCL
tear when seen in combination with a scapholunate, lunotriquetral, or TFC tear connotes
a greater degree and/or duration of carpal instability, and portends a poorer prognosis
following treatment. Recognition of this condition and further research into treatment
methods is needed. Level of Evidence: Level IV.
Key Words
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Note: To access the supplementary material accompanying this article, visit the December 2005 issue of Arthroscopy at www.arthroscopyjournal.org
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© 2005 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
