A Case Report On The Effect Of Early Mobilization In The Rehabilitation Of An Acrobat Post-Open Triangular Fibrocartilage Complex Repair

Abstract

The Triangular Fibrocartilage Complex (TFCC) is one of the more vital structures in the wrist. The TFCC functions as a stabilizer of the distal radioulnar joint and a conduit in the transmission of load in the upper extremity. Its integrity is important to allow the dynamic movement of the hand and wrist as well as in weight bearing. The TFCC can be subjected to excessive stresses, especially in elite performing athletes such as an acrobat, that can lead to its rupture.
 Partial or complete rupture of the TFCC of an elite athlete would benefit most from an open surgical repair. Surgery is then followed by hand therapy. However, due to the complexity of the TFCC, there is currently no gold standard in the rehabilitation of the TFCC. Albeit the globally practiced treatment post-surgery involves prolonged immobilization in a cast or a Muenster Splint that can range between 3 weeks and 8 weeks beforehand therapy can commence.
 The length of immobilization and time spent in hand therapy to recover range of motion, function, and strength can consume more than four months. This is a time that a performing acrobat may not have.
 This paper presents the effect of immediate hand therapy and early mobilization of the wrist of a professional acrobat who had an open surgical repair of a partial rupture of the TFCC and the Lunotriquetral ligament of the wrist.