Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 2/2013

01-02-2013 | Handsurgery

Subjective and objective results of arthroscopic debridement of ulnar-sided TFCC (Palmer type 1B) lesions with stable distal radio-ulnar joint

Authors: Eloy Cardenas-Montemayor, Jan Felix Hartl, Maya B. Wolf, Franck Marie Leclère, Jens Dreyhaupt, Peter Hahn, Frank Unglaub

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 2/2013

Login to get access

Abstract

Purpose

The purpose of this study was to determine functional and subjective results of patients who received arthroscopic debridement for their TFCC Palmer 1B lesions and to compare their results with those of arthroscopic suture repair.

Methods

Between March 2007 and August 2011, 36 patients were diagnosed with Palmer type 1B tears and underwent arthroscopic debridement. 31 patients (15 males and 16 females) were followed up for an average of 26.7 months (±17.4 months) postoperatively. Their average age was 36.7 years (±12.7 years). Follow-up included the determination of range of motion (ROM), grip strength, pain, and wrist scores (modified Mayo wrist score (MMWS), Disabilities of the Arm, Shoulder and Hand questionnaire (DASH score)).

Results

Postoperative ROM averaged 99.2 % for the extension/flexion arc, 95.5 % for the radial/ulnar deviation arc, and 99.4 % for the pronation/supination arc of motion when compared with the contralateral wrist. The MMWS was rated excellent in 48 % of patients, good in 39 %, fair in 13 %, and poor in 0 %. The average DASH score was 17.02 (±14.92). There was a significant reduction in pain. The grip strength was 96.7 % (±15.8), pulp-to-pulp pinch 101.9 % (±17.4), and the ulnar variance −0.12 ± 1.69 mm.

Conclusions

Arthroscopic debridement of Palmer type 1B lesions in stable DRUJ yields satisfactory to excellent results. Our study showed similar results compared with the studies of arthroscopic suture repair with shorter postoperative care and fewer complications.
Literature
1.
go back to reference Reiter A, Wolf MB, Schmid U et al (2008) Arthroscopic repair of Palmer 1B triangular fibrocartilage complex tears. Arthroscopy 24:1244–1250PubMedCrossRef Reiter A, Wolf MB, Schmid U et al (2008) Arthroscopic repair of Palmer 1B triangular fibrocartilage complex tears. Arthroscopy 24:1244–1250PubMedCrossRef
2.
go back to reference Corso SJ, Savoie FH, Geissler WB, Whipple TL, Jiminez W, Jenkins N (1997) Arthroscopic repair of peripheral avulsions of the triangular fibrocartilage complex of the wrist: a multicenter study. Arthroscopy 13:78–84PubMedCrossRef Corso SJ, Savoie FH, Geissler WB, Whipple TL, Jiminez W, Jenkins N (1997) Arthroscopic repair of peripheral avulsions of the triangular fibrocartilage complex of the wrist: a multicenter study. Arthroscopy 13:78–84PubMedCrossRef
3.
go back to reference Palmer AK (1990) Triangular fibrocartilage disorders: injury patterns and treatment. Arthroscopy 6:125–132PubMedCrossRef Palmer AK (1990) Triangular fibrocartilage disorders: injury patterns and treatment. Arthroscopy 6:125–132PubMedCrossRef
4.
go back to reference Estrella EP, Hung LK, Ho PC, Tse WL (2007) Arthroscopic repair of triangular fibrocartilage complex tears. Arthroscopy 23:729–737PubMedCrossRef Estrella EP, Hung LK, Ho PC, Tse WL (2007) Arthroscopic repair of triangular fibrocartilage complex tears. Arthroscopy 23:729–737PubMedCrossRef
5.
go back to reference Yao J, Lee AT (2011) All-arthroscopic repair of Palmer 1B triangular fibrocartilage complex tears using the FasT-Fix device. J Hand Surg Am 36:836–842PubMedCrossRef Yao J, Lee AT (2011) All-arthroscopic repair of Palmer 1B triangular fibrocartilage complex tears using the FasT-Fix device. J Hand Surg Am 36:836–842PubMedCrossRef
6.
go back to reference Wysocki RW, Richard MJ, Crowe MM, Leversedge FJ, Ruch DS (2012) Arthroscopic treatment of peripheral triangular fibrocartilage complex tears with the deep fibers intact. J Hand Surg Am 37:509–516PubMedCrossRef Wysocki RW, Richard MJ, Crowe MM, Leversedge FJ, Ruch DS (2012) Arthroscopic treatment of peripheral triangular fibrocartilage complex tears with the deep fibers intact. J Hand Surg Am 37:509–516PubMedCrossRef
7.
go back to reference Moritomo H, Masatomi T, Murase T, Miyake J, Okada K, Yoshikawa H (2010) Open repair of foveal avulsion of the triangular fibrocartilage complex and comparison by types of injury mechanism. J Hand Surg Am 35:1955–1963PubMedCrossRef Moritomo H, Masatomi T, Murase T, Miyake J, Okada K, Yoshikawa H (2010) Open repair of foveal avulsion of the triangular fibrocartilage complex and comparison by types of injury mechanism. J Hand Surg Am 35:1955–1963PubMedCrossRef
8.
go back to reference Iwasaki N, Minami A (2009) Arthroscopically assisted reattachment of avulsed triangular fibrocartilage complex to the fovea of the ulnar head. J Hand Surg Am 34:1323–1326PubMedCrossRef Iwasaki N, Minami A (2009) Arthroscopically assisted reattachment of avulsed triangular fibrocartilage complex to the fovea of the ulnar head. J Hand Surg Am 34:1323–1326PubMedCrossRef
9.
go back to reference Iwasaki N, Nishida K, Motomiya M, Funakoshi T, Minami A (2011) Arthroscopic-assisted repair of avulsed triangular fibrocartilage complex to the fovea of the ulnar head: a 2 to 4-year follow-up study. Arthroscopy 27:1371–1378PubMedCrossRef Iwasaki N, Nishida K, Motomiya M, Funakoshi T, Minami A (2011) Arthroscopic-assisted repair of avulsed triangular fibrocartilage complex to the fovea of the ulnar head: a 2 to 4-year follow-up study. Arthroscopy 27:1371–1378PubMedCrossRef
10.
go back to reference Waterman SM, Slade D, Masini BD, Owens BD (2010) Safety analysis of all-inside arthroscopic repair of peripheral triangular fibrocartilage complex. Arthroscopy 26:1474–1477PubMedCrossRef Waterman SM, Slade D, Masini BD, Owens BD (2010) Safety analysis of all-inside arthroscopic repair of peripheral triangular fibrocartilage complex. Arthroscopy 26:1474–1477PubMedCrossRef
11.
go back to reference Atzei A (2009) New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability. J Hand Surg Eur 34:582–591 Atzei A (2009) New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability. J Hand Surg Eur 34:582–591
12.
go back to reference Lubowitz JH, Poehling GG (2008) Keeping up with the literature: knee ligament, wrist triangular fibrocartilage tear, and suture bridge rotator cuff technique questions. Arthroscopy 24:1203–1204PubMedCrossRef Lubowitz JH, Poehling GG (2008) Keeping up with the literature: knee ligament, wrist triangular fibrocartilage tear, and suture bridge rotator cuff technique questions. Arthroscopy 24:1203–1204PubMedCrossRef
13.
14.
go back to reference Fujitani R, Omokawa S, Lida A, Santo S, Tanaka Y (2012) Reliability and clinical importance of teardrop angle measurement in intra-articular distal radius fracture. J Hand Surg Am 37:454–459PubMedCrossRef Fujitani R, Omokawa S, Lida A, Santo S, Tanaka Y (2012) Reliability and clinical importance of teardrop angle measurement in intra-articular distal radius fracture. J Hand Surg Am 37:454–459PubMedCrossRef
15.
go back to reference Ruch DS, Papadonikolakis A (2005) Arthroscopically assisted repair of peripheral triangular fibrocartilage complex tears: factors affecting outcome. Arthroscopy 21:1126–1130PubMedCrossRef Ruch DS, Papadonikolakis A (2005) Arthroscopically assisted repair of peripheral triangular fibrocartilage complex tears: factors affecting outcome. Arthroscopy 21:1126–1130PubMedCrossRef
16.
go back to reference Cooney WP, Bussey R, Dobyns JH, Linscheid RL (1987) Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 214:136–147PubMed Cooney WP, Bussey R, Dobyns JH, Linscheid RL (1987) Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 214:136–147PubMed
17.
go back to reference Cooney WP, Linscheid RL, Dobyns JH (1994) Triangular fibrocartilage tears. J Hand Surg Am 19:143–154PubMedCrossRef Cooney WP, Linscheid RL, Dobyns JH (1994) Triangular fibrocartilage tears. J Hand Surg Am 19:143–154PubMedCrossRef
18.
go back to reference Chen W, Wang J, Pan J, Zhang Q, Shao X, Zhang Y (2012) Primary results of Kienböck’s disease treated using balloon kyphoplasty system. Arch Orthop Trauma Surg 132:677–683PubMedCrossRef Chen W, Wang J, Pan J, Zhang Q, Shao X, Zhang Y (2012) Primary results of Kienböck’s disease treated using balloon kyphoplasty system. Arch Orthop Trauma Surg 132:677–683PubMedCrossRef
19.
go back to reference Kraus MD, Dehner C, Riepl C, Schöll H, Gebhard F (2012) A novel method of image-based navigation in fracture surgery. Arch Orthop Trauma Surg 132:741–750PubMedCrossRef Kraus MD, Dehner C, Riepl C, Schöll H, Gebhard F (2012) A novel method of image-based navigation in fracture surgery. Arch Orthop Trauma Surg 132:741–750PubMedCrossRef
20.
go back to reference Haugstvedt JR, Husby T (1999) Results of repair of peripheral tears in the triangular fibrocartilage complex using an arthroscopic suture technique. Scand J Plast Reconstr Surg Hand Surg 33:439–447PubMedCrossRef Haugstvedt JR, Husby T (1999) Results of repair of peripheral tears in the triangular fibrocartilage complex using an arthroscopic suture technique. Scand J Plast Reconstr Surg Hand Surg 33:439–447PubMedCrossRef
21.
go back to reference Millants P, De Smet L, Van Ransbeeck H (2002) Outcome study of arthroscopic suturing of ulnar avulsions of the triangular fibrocartilage complex of the wrist. Chir Main 21:298–300PubMedCrossRef Millants P, De Smet L, Van Ransbeeck H (2002) Outcome study of arthroscopic suturing of ulnar avulsions of the triangular fibrocartilage complex of the wrist. Chir Main 21:298–300PubMedCrossRef
22.
go back to reference Shih JT, Lee HM, Tan CM (2002) Early isolated triangular fibrocartilage complex tears: management by arthroscopic repair. J Trauma 53:922–927PubMedCrossRef Shih JT, Lee HM, Tan CM (2002) Early isolated triangular fibrocartilage complex tears: management by arthroscopic repair. J Trauma 53:922–927PubMedCrossRef
23.
go back to reference Tünnerhoff HG, Haussmann P (2001) What are the indications for arthroscopic repair of ulnar tears of the TFCC? Handchir Mikrochir Plast Chir 33:239–244PubMedCrossRef Tünnerhoff HG, Haussmann P (2001) What are the indications for arthroscopic repair of ulnar tears of the TFCC? Handchir Mikrochir Plast Chir 33:239–244PubMedCrossRef
Metadata
Title
Subjective and objective results of arthroscopic debridement of ulnar-sided TFCC (Palmer type 1B) lesions with stable distal radio-ulnar joint
Authors
Eloy Cardenas-Montemayor
Jan Felix Hartl
Maya B. Wolf
Franck Marie Leclère
Jens Dreyhaupt
Peter Hahn
Frank Unglaub
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 2/2013
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-012-1643-z

Other articles of this Issue 2/2013

Archives of Orthopaedic and Trauma Surgery 2/2013 Go to the issue