The Management of Dorsal Radiocarpal Ligament Tears

The dorsal radiocarpal ligament (DRCL) has been implicated in both volar and dorsal intercalated segmental instabilities and has a role in midcarpal instability. 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 and lunotriquetral ligament injuries as well as triangular fibrocartilage tears. Isolated DRCL tears can be solely responsible for wrist pain. The presence of an associated DRCL tear when seen in combination with a scapholunate, lunotriquetral, or triangular fibrocartilage tear connotes a greater degree and/or duration of carpal instability, and portends a poorer prognosis after treatment. Good results are obtained after arthroscopic repair of isolated DRCL tears. Results of DRCL repairs are less predictable when seen in combination with other types of carpal pathology. Recognition of this condition and further research into treatment methods is needed.