Original article| Volume 21, ISSUE 12, P1486.e1-1486.e8, December 2005

Arthroscopic Dorsal Radiocarpal Ligament Repair

  • David J. Slutsky
    Address correspondence and reprint requests to David J. Slutsky, M.D., F.R.C.S.C., 3475 Torrance Blvd, Suite F, Torrance, CA 90503.
    Department of Orthopedics, UCLA School of Medicine, Los Angeles, California and Private Practice
    Search for articles by this author
      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

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mitsuyasu H.
        • Patterson R.M.
        • Shah M.A.
        • Buford W.L.
        • Iwamoto Y.
        • Viegas S.F.
        The role of the dorsal intercarpal ligament in dynamic and static scapholunate instability.
        J Hand Surg [Am]. 2004; 29: 279-288
        • Ruch D.S.
        • Smith B.P.
        Arthroscopic and open management of dynamic scaphoid instability.
        Orthop Clin North Am. 2001; 32: 233-240
        • Short W.H.
        • Werner F.W.
        • Green J.K.
        • Weiner M.M.
        • Masaoka S.
        The effect of sectioning the dorsal radiocarpal ligament and insertion of a pressure sensor into the radiocarpal joint on scaphoid and lunate kinematics.
        J Hand Surg [Am]. 2002; 27: 68-76
        • Viegas S.F.
        • Yamaguchi S.
        • Boyd N.L.
        • Patterson R.M.
        The dorsal ligaments of the wrist.
        J Hand Surg [Am]. 1999; 24: 456-468
        • Horii E.
        • Garcia-Elias M.
        • An K.N.
        A kinematic study of luno-triquetral dissociations.
        J Hand Surg [Am]. 1991; 16: 355-362
        • Moritomo H.
        • Viegas S.F.
        • Elder K.W.
        Scaphoid nonunions.
        J Hand Surg [Am]. 2000; 25: 520-528
        • Viegas S.F.
        • Patterson R.M.
        • Peterson P.D.
        Ulnar-sided perilunate instability.
        J Hand Surg [Am]. 1990; 15: 268-278
        • Ruch D.S.
        • Poehling G.G.
        Wrist arthroscopy.
        in: Green D.P. Hotchkiss R.N. Pederson W.C. Green’s operative hand surgery. Ed 4. Churchill Livingstone, Philadelphia1999: 200-206
        • Slutsky D.J.
        Arthroscopic repair of dorsal radiocarpal ligament tears.
        Arthroscopy. 2002; 18 (available online at E49
        • Goldfarb C.A.
        • Stern P.J.
        • Kiefhaber T.R.
        Palmar midcarpal instability.
        J Hand Surg [Am]. 2004; 29: 258-263
        • Slutsky D.J.
        Volar portals in wrist arthroscopy.
        J Am Soc Surg Hand. 2002; 2: 225-232
        • Watson H.K.
        • Weinzweig J.
        Physical examination of the wrist.
        Hand Clin. 1997; 13: 17-34
        • Slutsky D.J.
        Wrist arthroscopy through a volar radial portal.
        Arthroscopy. 2002; 18: 624-630
        • Berger R.A.
        Arthroscopic anatomy of the wrist and distal radioulnar joint.
        Hand Clin. 1999; 15: 393-413
        • Zachee B.
        • De Smet L.
        • Fabry G.
        Frayed ulno-triquetral and ulno-lunate ligaments as an arthroscopic sign of longstanding triquetro-lunate ligament rupture.
        J Hand Surg [Br]. 1994; 19: 570-571
        • Moran S.L.
        • Cooney W.P.
        • Berger R.A.
        • Strickland J.
        Capsulodesis for the treatment of chronic scapholunate instability.
        J Hand Surg [Am]. 2005; 30: 16-23
        • Geissler W.B.
        • Freeland A.E.
        • Savoie F.H.
        • McIntyre L.W.
        • Whipple T.L.
        Intracarpal soft-tissue lesions associated with an intra-articular fracture of the distal end of the radius.
        J Bone Joint Surg Am. 1996; 78: 357-365
        • Lichtman D.M.
        • Bruckner J.D.
        • Culp R.W.
        • Alexander C.E.
        Palmar midcarpal instability.
        J Hand Surg [Am]. 1993; 18: 307-315
        • Wright T.W.
        • Dobyns J.H.
        • Linscheid R.L.
        • Macksoud W.
        • Siegert J.
        Carpal instability non-dissociative.
        J Hand Surg [Br]. 1994; 19: 763-773
        • Bednar J.M.
        • Osterman A.L.
        Carpal Instability.
        J Am Acad Orthop Surg. 1993; 1: 10-17
        • Watson H.K.
        • Weinzweig J.
        Triquetral impingement ligament tear (tilt).
        J Hand Surg [Br]. 1999; 24: 321-324
        • Mooney J.F.
        • Poehling G.G.
        Disruption of the ulnolunate ligament as a cause of chronic ulnar wrist pain.
        J Hand Surg [Am]. 1991; 16: 347-349
        • Osterman A.L.
        Wrist arthroscopy.
        in: Green D.P. Hotchkiss R.N. Pederson W.C. Green’s operative hand surgery. Ed 4. Churchill Livingstone, Philadelphia1999: 207-222
        • Slater Jr, R.R.
        • Safian C.C.
        • Laubach J.E.
        Vascular anatomy of the dorsal wrist ligaments. 2000 (Presented at the 55th Annual Meeting of the American Society for Surgery of the Hand, Seattle, WA)
        • Moskal M.J.
        • Savoie III, F.H.
        • Field L.D.
        Arthroscopic capsulodesis of the lunotriquetral joint.
        Clin Sports Med. 2001; 20: 141-153