Long-term Outcomes of Arthroscopic Debridement and Thermal Shrinkage for Isolated Partial Intercarpal Ligament Tears

Abstract

A retrospective analysis was performed based on the medical records and imaging studies of 16 wrists (14 patients) with isolated partial intercarpal ligament tears (scapholunate ligament: 6 wrists, lunotriquetral ligament, 10 wrists) treated with arthroscopic debridement and thermal shrinkage. Three wrists had Geissler grade 1 tears and 13 wrists had grade 2 tears. Mean follow-up was 52.8 months. Overall pain visual analog scale scores improved significantly (P,. 05) at rest and during activities of daily living and heavy manual work. Mean flexion-extension arc was 136.5 degrees. Mean postoperative grip strength was 106 lb, which was significantly better than preoperative grip strength. Mean modified Mayo wrist score was 70 preoperatively and 94.7 postoperatively, a significant improvement. Overall functional outcomes according to the modified Mayo wrist score were rated as excellent in 13 wrists and good in 3. No patient had radiographic evidence of instability or arthritic changes. The scapholunate and lunotriquetral intervals in all patients were less than 3 mm on neutral and pronation grip radiographs. On lateral radiographs, no signs of intercalated segmental instability were seen, with a mean scapholunate angle of 55.3 degrees. The results of this study suggest that arthroscopic debridement and thermal shrinkage provide symptomatic pain relief and prevention of intercarpal instability for a significant period of time in patients with partial intercarpal ligament tear.