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J Wrist Surg 2025; 14(03): 246-254
DOI: 10.1055/s-0044-1785505
Scientific Article

Dorsal Intercarpal Ligament Tears: An Arthroscopic Classification and Clinical Outcomes Study

Authors

  • Lorenzo Merlini‡   *

    1   Institut de la Main, International Wrist Center, Clinique Bizet, Paris, France

  • Sze Ryn Chung  ‡   *

    1   Institut de la Main, International Wrist Center, Clinique Bizet, Paris, France
    2   Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore, Singapore

  • Martin Caloia

    3   Division of Hand and Upper Extremity Surgery, Austral University Hospital, Buenos Aires, Argentina

Funding None.
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Abstract

Background The dorsal intercarpal (DIC) ligament plays a significant role in carpal stability and is often associated with other carpal ligament injuries. Isolated DIC ligament injuries are rare and can present as a ligament avulsion, bony avulsion, or attenuation due to chronic injury. Previously, we described the first isolated DIC ligament avulsion and proposed an arthroscopic repair technique. This article presents an arthroscopic classification of DIC ligament complex injuries and outcomes in a larger series of patients.

Materials and Methods A retrospective review was conducted on 16 patients who had undergone arthroscopic repair of the DIC ligament from 2018 to 2022. Intraoperative arthroscopic findings were documented, leading to the proposal of a classification system for DIC ligament tears. Pre- and postoperative outcomes, including the range of motion, grip strength, visual analog scale (VAS) pain scores, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) outcomes, were assessed in this cohort.

Results At a mean follow-up of 17.8 months, there was a statistically significant improvement in wrist flexion (65.3 to 74.3 degrees), wrist extension (77.8 to 84.5 degrees), comparative grip strength (46.4 to 87% compared with contralateral wrist), VAS score (6.3 to 0.6), and QuickDASH score (54.8 to 4.5). Four out of 16 patients (25%) had isolated DIC ligament tears, and the remaining 12 (75%) had concomitant intercarpal ligament injuries.

Conclusion The study highlights the critical role of the DIC ligament in carpal stability and introduces an arthroscopic classification for evaluating this lesion. Surgical options for different types of DIC ligament tears were also discussed.

Level of Evidence Level III, Retrospective study.

Keywords

wrist arthroscopy - carpal ligaments - dorsal intercarpal ligament - extrinsic ligament repair - comprehensive classification

Ethical Approval

Ethical approval for this study was obtained from the Institutional Review Board (reference study 2023/7).


* These two authors contributed equally to this work and are designated as co-first authors.




Publication History

Received: 15 December 2023

Accepted: 22 February 2024

Article published online:
30 March 2024

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