Abstract
Background and purposeTo investigate the outcome of open versus arthroscopic repair of injuries of the triangular fibrocartilage complex (TFCC).MethodsAn electronic literature search of articles published between January 1, 1985, and May 26, 2016, in PubMed, Embase, and the Cochrane Library was carried out in May 2016 and updated in March and December 2017. Studies comparing open and arthroscopic repair of TFCC injury with a mean follow up of more than 1 year were eligible for inclusion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guided the extraction and reporting of data. The methodological quality of the included articles was assessed with the Cochrane Collaboration’s tool for assessing risk of bias. The primary outcome measure was the rate of postoperative distal radioulnar joint (DRUJ) re-instability. Secondary outcome measures were range of motion (ROM), grip strength, residual pain, functional wrist scores and the rates of complications and re-operations.ResultsA total of 868 articles were identified by the electronic search. After duplicate removal and subsequent study selection, a total of two studies were included in this systematic review. The methodological quality of the included articles displayed risks of bias. There was no difference in DRUJ re-instability between open and arthroscopic repair of the TFCC. There were no differences in obtained postoperative ROM, grip strength or values in functional outcome scores, between open and arthroscopic TFCC repair in the two included studies, except for the Disability of the Arm Shoulder and Hand (DASH) questionnaire - in favor of arthroscopic surgery - in one of the included studies.ConclusionsThis systematic review shows comparable results between open and arthroscopic repair of the TFCC, in terms of DRUJ re-instability and functional outcome scores. There is insufficient evidence to recommend one technique over the other in clinical practice. There is an immense lack of comparison studies with high level of evidence in the area of wrist ligament repair and reconstruction, including TFCC-injuries and DRUJ-instability.
Highlights
Injury to the triangular fibrocartilage complex (TFCC) is the most common wrist ligament injury
More than 40% of displaced distal radial fractures are associated with a TFCC injury
Injury to the TFCC is sometimes associated with instability of the distal radioulnar joint (DRUJ)
Summary
Injury to the triangular fibrocartilage complex (TFCC) is the most common wrist ligament injury. More than 40% of displaced distal radial fractures are associated with a TFCC injury Injury to the TFCC is sometimes associated with instability of the distal radioulnar joint (DRUJ). Lindau et al (2000) demonstrated that instability of the DRUJ is a negative factor in terms of clinical outcome after distal radial fractures in young patients, independent of radiographic findings. In patients with post-traumatic wrist pain but normal standard radiographs, 42% were found to have TFCC injuries (Adolfsson 1994). To investigate the outcome of open versus arthroscopic repair of injuries of the triangular fibrocartilage complex (TFCC)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
