Triquetral impingement ligament tear (TILT)

Ulnar wrist pain is a complex problem whose cause often remains elusive. A diagnostic triad of localized triquetral pain, history of a wrist hyperflex ion injury, and normal radiographs, accompanied by ulnar wrist smelling and limited wrist motion, is often attributable to a syndrome we have termed t riquetral impingement ligament tear (TILT), The mechanism of injury causes a cuff of fibrous tissue to be displaced distally from the ulnar sling mech anism, resulting in chronic impingement on the triquetrum that causes hyper aemia, loss of articular cartilage, and softening of the bone. Surgical rep air consists of simply excising the impinging fibrous cuff. The outcome of 44 patients treated for TILT over a 6-year period is reviewed. In all cases , TILT repair resulted in improved wrist motion and strength. Ninety-five p ercent of patients reported a significant improvement in pain both at rest and with activity.