Evidence map›Paper›PMID 42237126›Full record

SynthesisBMC musculoskeletal disorders2026

Open versus arthroscopic management of acute and chronic distal radioulnar joint instability: a systematic review and meta-analysis.

Galal Hegazy, Ahmed I Hammouda, Mohamed Ramadan, Abdulhamid Elzoghby, Ehab Elzahed, Ibrahem El-Sebaey, Ahmed Elgeushy, Mahmoud Seddik

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Galal HegazyDepartment of Orthopaedic Surgery, Al-Azhar University, P.O. Box 11751, El Nassr Street, Nasr City, Cairo, 11751, Egypt. glalhegazy@azhar.edu.eg.ORCID http://orcid.org/0000-0001-9728-2064
Ahmed I HammoudaDepartment of Orthopaedic Surgery, Al-Azhar University, P.O. Box 11751, El Nassr Street, Nasr City, Cairo, 11751, Egypt.
Mohamed RamadanDepartment of Orthopaedic Surgery, Al-Azhar University, P.O. Box 11751, El Nassr Street, Nasr City, Cairo, 11751, Egypt.
Abdulhamid ElzoghbyDepartment of Orthopaedic Surgery, Al-Azhar University, P.O. Box 11751, El Nassr Street, Nasr City, Cairo, 11751, Egypt.
Ehab ElzahedDepartment of Orthopaedic Surgery, Al-Azhar University, P.O. Box 11751, El Nassr Street, Nasr City, Cairo, 11751, Egypt.
Ibrahem El-SebaeyDepartment of Orthopaedic Surgery, Al-Azhar University, P.O. Box 11751, El Nassr Street, Nasr City, Cairo, 11751, Egypt.
Ahmed ElgeushyDepartment of Orthopaedic Surgery, Al-Azhar University, P.O. Box 11751, El Nassr Street, Nasr City, Cairo, 11751, Egypt.
Mahmoud SeddikDepartment of Orthopaedic Surgery, Al-Azhar University, P.O. Box 11751, El Nassr Street, Nasr City, Cairo, 11751, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFoveal triangular fibrocartilage complex (TFCC) repair can restore distal radioulnar joint (DRUJ) stability, but whether open or arthroscopic techniques provide superior clinical outcomes remains uncertain. This systematic review and meta-analysis compared functional outcomes, DRUJ stability, and complications between open versus arthroscopic foveal TFCC repair for acute and chronic post-traumatic DRUJ instability.

methodsPubMed, Scopus, and Cochrane CENTRAL were searched initially in January 2026 and updated on 15 April 2026 to identify comparative studies of open versus arthroscopic TFCC foveal repair published from January 2000 onward. Adult patients undergoing open or arthroscopic TFCC foveal repair for DRUJ instability were included. Non-comparative studies, abstracts, and non-English publications were excluded. Extracted outcomes included Modified Mayo Wrist Score (MMWS), Disabilities of the Arm, Shoulder and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), Visual Analogue Scale (VAS) score for pain, grip strength, range of motion, recurrent instability, and complications. Random-effects meta-analysis pooled standardized mean differences (SMDs) for continuous outcomes and odds ratios (ORs) for binary outcomes. Risk of bias was assessed using ROBINS-I, and certainty of evidence using GRADE. Exploratory subgroup analysis by injury chronicity at study level was performed.

resultsFive observational studies (Level II-III evidence; 322 wrists: 181 open, 141 arthroscopic) met inclusion criteria. ROBINS-I rated two studies at moderate and three at serious risk of bias; GRADE certainty was low to very low across outcomes. Pooled results showed no statistical differences: MMWS (SMD - 0.12, 95% CI - 0.47 to 0.23; I² = 0%, τ² = 0; p = 0.719); DASH score (SMD 0.22, 95% CI - 0.96 to 1.40; I² = 86.7%, τ² = 0.48; p < 0.0001); PRWE (SMD - 0.24, 95% CI - 2.85 to 2.38; I² = 93.3%, τ² = 1.03; p < 0.0001); VAS (SMD - 0.35, 95% CI - 1.69 to 0.99; I² = 89.9%, τ² = 0.63; p < 0.0001); recurrent instability OR (1.00, 95% CI 0.19 to 5.37; I² = 63.2%, τ² = 1.18; p = 0.028). Exploratory subgroup synthesis restricted to predominantly chronic cohorts did not materially alter pooled estimates.

conclusionsBoth open and arthroscopic foveal TFCC repair can improve function, pain, motion, grip strength, and distal radioulnar joint stability, but current comparative evidence does not demonstrate clear superiority of either technique. Because the available evidence is limited to a small number of non-randomized studies with substantial heterogeneity and low certainty, the absence of statistically significant differences should be interpreted cautiously and should not be considered evidence of clinical equivalence. In addition, although SMDs were appropriate for the present meta-analysis given heterogeneity in outcome reporting, they reduce the clinical interpretability. Surgical choice should therefore remain individualized until higher-quality comparative studies become available.

trial registrationPROSPERO registration: CRD42025638530.

Indexed as

ArthroscopyJoint InstabilityTriangular FibrocartilageWrist JointChronic DiseaseHumansRange of Motion, ArticularTreatment OutcomeArthroscopic repairDistal radioulnar joint instabilityMeta-analysisOpen repairSystematic reviewTFCC foveal repairTriangular fibrocartilage complex

Identifiers

PMID42237126
PMCPMC13242675

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.