Increase of weight-bearing capacity of patients with lesions of the TFCC using a wrist brace
2021
Abstract Study design Retrospective cross-sectional case series Background Lesions of the triangular fibrocartilage complex (TFCC) can result in pain during axial load and unstable distal radioulnar joint (DRUJ). Conventional wrist orthoses decrease initial pain sufficiently but also prevent any movement during recovery and do not contribute to the stabilisation of the DRUJ. Purpose In this retrospective analysis, we tested if the weight-bearing capacity of patients with lesions of the triangular fibrocartilage complex was increased by wearing a brace that stabilises the distal radioulnar joint. Methods Twenty-three patients had an arthroscopically confirmed TFCC lesion. We compared preoperative dynamic weight-bearing capacity of both hands with and without a commercially available wrist brace (WristWidget ®). Subgroup analysis was performed for stability of the distal radioulnar joint and aetiology of the TFCC lesion. The dynamic ulnar variance was measured in a modified weight bearing test. We used parametric tests for normally distributed values. Results The weight-bearing capacity of the hand with TFCC lesion was significantly lower than of the control hand. With brace, the affected hand showed a significant increase, but not to values of the contralateral hand. The device had no effect on the control hand. Twelve patients with unstable DRUJ had a lower weight-bearing capacity compared to the eleven with stable joint. The patients with unstable joint seemed to have a higher relative increase. The same was true for patients with traumatic lesions of the TFCC compared to those with a degenerative lesion. Conclusion The use of a wrist brace significantly increases the weight-bearing capacity and therefore the maximum tolerated axial load of patients with a lesion of the TFCC. Patients with traumatic lesion or unstable DRUJ tend to show lower values than with degenerative lesions or stable joints.
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