Functional results of arthroscopic triangular fibrocartilage complex reconstruction in chronic distal radioulnar joint instability

Abstract

PurposeTears 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 mini-invasive technique for TFCC reconstruction using the palmaris longus (PL) tendon via arthroscopy. MethodsWe examined the cases of 21 adult patients [20 men and 1 woman; age range, 19−24 years (mean age, 22.4 years)] treated for chronic and irreparable TFCC tears from September 1999 to September 2011. We used the arthroscopic TFCC reconstruction method with the PL tendon for all chronic and irreparable TFCC injuries with DRUJ instability in our clinic. Thereafter, the patients underwent a rehabilitation program, which included wrist motion and occupational therapy. The time period from the event causing the tear to the operation ranged from 14 months to 28 months (mean duration, 22.6 months). All the patients had negative, zero, or mildly positive (<2 mm) ulnar variance. ResultsThe results were graded using the Mayo modified wrist score. Of the 21 patients, 11 rated their wrists as “excellent,” 9 as “good,” and 1 as “fair.” None of the patients developed wound infections or complications. ConclusionsThe results of this study suggest that arthroscopic TFCC reconstruction using the PL tendon is an effective method for treating chronic and irreparable TFCC tears with DRUJ instability.