Outcomes of surgical management of Palmer type IB triangular fibrocartilage complex injuries

Abstract

Palmer type IB triangular fibrocartilage complex (TFCC) is one of the most common causes of ulnar wrist pain. The primary surgical treatment for these lesions is open and wrist arthroscopic technique to repair TFCC. This study was carried out to describe the result of both techniques in the treatment of type IB TFCC injuries. A retrospective study was carried out on 18 patients with surgical treatment at the Hospital of Traumatology and Orthopaedics of Ho Chi Minh City from 2019 to 2021. Results showed that there were 13 female patients with a mean age of 34.8±8.1 years old, and 5 male patients with a mean age of 19.4±2.3 years old. Of which, 10 patients underwent arthroscopic surgery, accounting for 55.6%, and 8 underwent open surgery, accounting for 44.4%. The mean follow-up time of the arthroscopic group was 17.6±9.7 months, and in the open surgery group was 18.8±4.6 months. The mean visual analog scale (VAS) score in the arthroscopic group was 1.3±1.8, and in the open surgery group was 0.62±0.74 at the time of final follow-up. The arthroscopic group had an average score of 83±15.1, and the open surgery group was 88.1±8.4 on the Mayo modified wrist score (p>0.05). In all cases, there were 8 excellent cases, 6 good cases, 3 satisfactory cases and 1 poor case. The common complications in the arthroscopic group were ulnar nerve injuries in 2 cases and a prominent suture knot in 2 cases, followed by extensor carpi ulnar tendonitis in 1 case. In the open surgery group, there were 2 cases of prominent suture knots and 1 case of pin infection. In conclusion, both techniques of treating Palmer IB TFCC injuries gave similar good results, the choice of method depends on the surgeon’s reference. However, the risk of ulnar nerve injury was higher in the arthroscopic group.