Management of isolated triangular fibrocartilage complex perforations of the wrist

Abstract

The purpose of this study was to examine surgical and therapeutic management of patients with triangular fibrocartilage complex perforations of the wrist. Anatomy, symptoms, diagnosis, surgical treatment, and therapeutic intervention were examined. Twenty-three patients with symptomatic triangular fibrocartilage complex tears were followed after arthroscopic debridement. Emphasis of hand therapy was placed on decreasing edema and obtaining maximum range of motion, strength, and function. Twenty-two of the 23 patients had been employed at the time of their injuries. Seventeen patients (77%) were asymptomatic following triangular fibrocartilage complex debridement and hand rehabilitation. The mean time for return to work was 5.5 weeks after arthroscopy and therapy. Retrospective, post-operative functional results compared with those of the opposite unaffected limbs were: grip strength, 71%; lateral pinch, 79%; three jaw-chuck, 83%; pronation, 94%; supination, 85%; wrist palmar flexion, 87%; wrist dorsiflexion, 86%; radial deviation, 91 %; and ulnar deviation, 95%. This study suggests favorable functional results following arthroscopic triangular fibrocartilage complex debridement and hand rehabilitation.