Abstract
BackgroundTears in the triangular fibrocartilage complex (TFCC) often manifest as ulnar wrist pain and limited wrist function. In chronic cases, the treatment of large tears with irreparable TFCC degeneration combined with distal radioulnar joint (DRUJ) instability is difficult. In the current report, we describe the outcomes of a minimally invasive technique for TFCC reconstruction using the free palmaris longus (PL) tendon via arthroscopy.MethodsWe examined the cases of 67 adult patients [54 men and 13 women; age range, 19–34 years (mean age, 26.4 years)] treated for chronic and irreparable TFCC tears from 2001 to 2019. We used the arthroscopic TFCC reconstruction method with the free PL tendon for all chronic and irreparable TFCC injuries with DRUJ instability in our clinic. Thereafter, the patients underwent the rehabilitation program, which included wrist motion and occupational therapy. The mean time period from the event causing the tear to the operation was 22.6 months.ResultsThe function results of these patients significantly improved, and the ulnar wrist pain significantly decreased at postoperative follow-up. Of the 67 patients, 38 rated their wrists as “excellent,” 26 as “good,” and 3 as “fair.” None of the patients developed wound infections or complications.ConclusionsThe results of this study suggest that arthroscopic TFCC reconstruction using the free PL tendon is an effective method for treating chronic and irreparable TFCC tears with DRUJ instability.
Highlights
Tears in the triangular fibrocartilage complex (TFCC) often manifest as ulnar wrist pain and limited wrist function
In the current study, we describe the outcomes of a TFCC reconstruction using the free palmaris longus (PL) tendon via arthroscopy
There were 37 (55.2%) patients who had negative TFCC findings at Magnetic resonance (MRI) study, but the pathology was confirmed through arthroscopy
Summary
Tears in the triangular fibrocartilage complex (TFCC) often manifest as ulnar wrist pain and limited wrist function. The treatment of large tears with irreparable TFCC degeneration combined with distal radioulnar joint (DRUJ) instability is difficult. Tears in the triangular fibrocartilage complex (TFCC) are often indicated by ulnar wrist pain and limited wrist function. The TFCC is composed of the central fibrocartilage, the dorsal and palmar distal radioulnar ligaments, and the sheath of the extensor carpi ulnaris (ECU) tendon. The vascularity of the TFCC enables surgeons to repair acute peripheral tears, with excellent outcomes. The TFCC provides primary stability to the distal radioulnar joint (DRUJ). The TFCC is an important stabilizer of the DRUJ when the distal radioulnar ligaments become taut. The TFCC stabilizes the ulnar carpus via the ulnar carpal ligament complex.
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