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Arthroscopic Transosseous Repair for both Proximal and Distal Components of Peripheral Triangular Fibrocartilage Complex Tear

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Abstract

Background

Tears of the triangular fibrocartilage complex (TFCC) can result in instability of the distal radioulnar joint (DRUJ) and ulnar-sided wrist pain. This study evaluates clinical results of arthroscopic transosseous repair for both proximal and distal components of TFCC tear with DRUJ instability.

Materials and Methods

Ten patients who underwent both proximal component and distal component of TFCC repair were retrospectively reviewed. The proximal component of TFCC was repaired through arthroscopic one-tunnel transosseous suture technique, and the combined distal component tear was repaired to the ulnar capsule using same transosseous tunnel in all cases. Visual analog scale (VAS) score for pain, wrist range of motion, grip strength, and postoperative complications were evaluated after a mean followup period of 23.5 months, and each patient was rated according to modified Mayo wrist score and quick disabilities of the arm, shoulder, and hand (DASH) questionnaire.

Results

On arthroscopic findings, the hook test confirmed the proximal component of the TFCC tear and visible capsular detachment from TFCC confirmed combined distal component tear in all patients. At final followup, 7 patients had normal stability of DRUJ and 3 patients showed mild laxity compared with the contralateral side. The mean VAS for pain perception decreased from 4.1 to 0.7, and grip strength was increased significantly. The modified Mayo wrist score and Quick DASH score showed significant functional improvement. No surgery-related complications occurred.

Conclusions

Arthroscopic one-tunnel transosseous TFCC foveal repair and simulatneous transosseous capsular repair of distal component can be a safe and effective strategy for repair of complete TFCC tear combined with DRUJ instability.

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References

  1. Palmer AK, Werner FW. The triangular fibrocartilage complex of the wrist – Anatomy and function. J Hand Surg Am 1981;6:153–62.

    Article  CAS  Google Scholar 

  2. Nakamura T, Yabe Y, Horiuchi Y. Functional anatomy of the triangular fibrocartilage complex. J Hand Surg Br 1996;21:581–6.

    Article  CAS  Google Scholar 

  3. Palmer AK. Triangular fibrocartilage disorders: Injury patterns and treatment. Arthroscopy 1990;6:125–32.

    Article  CAS  Google Scholar 

  4. Atzei A, Rizzo A, Luchetti R, Fairplay T. Arthroscopic foveal repair of triangular fibrocartilage complex peripheral lesion with distal radioulnar joint instability. Tech Hand Up Extrem Surg 2008;12:226–35.

    Article  Google Scholar 

  5. Iwasaki N, Minami A. Arthroscopically assisted reattachment of avulsed triangular fibrocartilage complex to the fovea of the ulnar head. J Hand Surg Am 2009;34:1323–6.

    Article  Google Scholar 

  6. Desai MJ, Hutton WC, Jarrett CD. Arthroscopic repair of triangular fibrocartilage tears: A biomechanical comparison of a knotless suture anchor and the traditional outside-in repairs. J Hand Surg Am 2013;38:2193–7.

    Article  Google Scholar 

  7. Atzei A. New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability. J Hand Surg Eur Vol 2009;34:582–91.

    Article  CAS  Google Scholar 

  8. Nakamura T, Sato K, Okazaki M, Toyama Y, Ikegami H. Repair of foveal detachment of the triangular fibrocartilage complex: Open and arthroscopic transosseous techniques. Hand Clin 2011;27:281–90.

    Article  Google Scholar 

  9. Wysocki RW, Richard MJ, Crowe MM, Leversedge FJ, Ruch DS. Arthroscopic treatment of peripheral triangular fibrocartilage complex tears with the deep fibers intact. J Hand Surg Am 2012;37:509–16.

    Article  Google Scholar 

  10. Tay SC, Tomita K, Berger RA. The “ulnar fovea sign” for defining ulnar wrist pain: An analysis of sensitivity and specificity. J Hand Surg Am 2007;32:438–44.

    Article  Google Scholar 

  11. Nakamura T, Makita A. The proximal ligamentous component of the triangular fibrocartilage complex. J Hand Surg Br 2000;25:479–86.

    CAS  PubMed  Google Scholar 

  12. Shinohara T, Tatebe M, Okui N, Yamamoto M, Kurimoto S, Hirata H, et al. Arthroscopically assisted repair of triangular fibrocartilage complex foveal tears. J Hand Surg Am 2013;38:271–7.

    Article  Google Scholar 

  13. Ruch DS, Anderson SR, Ritter MR. Biomechanical comparison of transosseous and capsular repair of peripheral triangular fibrocartilage tears. Arthroscopy 2003;19:391–6.

    Article  Google Scholar 

  14. Bain GI, McGuire D, Lee YC, Eng K, Zumstein M. Anatomic foveal reconstruction of the triangular fibrocartilage complex with a tendon graft. Tech Hand Up Extrem Surg 2014;18:92–7.

    Article  Google Scholar 

  15. Reiter A, Wolf MB, Schmid U, Frigge A, Dreyhaupt J, Hahn P, et al. Arthroscopic repair of palmer 1B triangular fibrocartilage complex tears. Arthroscopy 2008;24:1244–50.

    Article  Google Scholar 

  16. Geissler WB. Arthroscopic knotless peripheral triangular fibrocartilage repair. J Hand Surg Am 2012;37:350–5.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Korea University Anam Hospital, 73, Inchon-Ro, Sungbuk-Gu, Seoul, 06334, Korea

    Ji Hun Park &  Jong Woong Park

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  1. Ji Hun Park
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  2. Jong Woong Park
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Correspondence to Jong Woong Park.

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Park, J.H., Woong Park, J. Arthroscopic Transosseous Repair for both Proximal and Distal Components of Peripheral Triangular Fibrocartilage Complex Tear. IJOO 52, 596–601 (2018). https://doi.org/10.4103/ortho.IJOrtho_598_16

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  • DOI: https://doi.org/10.4103/ortho.IJOrtho_598_16

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