Ulnar Extrinsic Ligament Tears: Clinical Presentation,Surgical Management,and Outcomes of Surgical Repair Extending Into Long-term Follow-up

Abstract

Background:

Injury to the ulnar extrinsic ligaments often causes significant pain without obvious instability. This study aims to further investigate the clinical presentations and outcomes following ulnar extrinsic ligament repair.

Methods:

A retrospective analysis of 113 patients who underwent ulnar extrinsic ligament surgery was conducted. Collected data included demographics, clinical presentation, intraoperative findings, and postoperative outcomes, such as grip strength, Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores, complications, and reoperations. Continuous variables were represented by the mean and standard deviation, whereas categorical variables were expressed as counts and percentages. A matched pair T-test was performed for grip strength and Q-DASH changes from pre-op to post-op for patients who had data available at both time points.

Results:

Preoperative symptoms primarily included wrist pain (100%), difficulties in rotation (16%), and weakness (16%). Intraoperatively, split tears (75%) and avulsions (11%) were common, often accompanied by triangular fibrocartilage complex (TFCC) pathology (83%). Postoperatively, grip strength improved significantly (P < .001), with a mean reduction of 30.3 points in Q-DASH scores (P < .001). Eighty percent of patients returned to work fully, 14% returned in a limited capacity, and 6% were unable to return to work. The overall complication rate was 9%. Reoperation rate was 8.8%. At final follow-up, 83% of patients reported that they would elect to undergo the same surgery again.

Conclusions:

Ulnar extrinsic ligament injuries frequently present with wrist pain and TFCC pathology. Surgical repair of ulnar extrinsic ligament injuries improves grip strength and functional outcomes with high patient satisfaction.