Arthroscopic triangular fibrocartilage complex reconstruction with free tendon graft for chronic distal radioulnar joint instability

• Published in: Journal of orthopaedic surgery and research Vol. 16; no. 1; pp. 678 - 8
• Main Authors: Yeh, Kuang-Ting, Shih, Jui-Tien
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.11.2021; BioMed Central; BMC
• Subjects: Adult; Arthralgia; Arthroscopy; Arthroscopy - methods; Degeneration; Female; Health aspects; Humans; Injuries; Instability; Irreparable; Joint Instability - diagnostic imaging; Joint Instability - surgery; Ligaments; Male; Medical imaging; Medical research; Medicine, Experimental; Nonsteroidal anti-inflammatory drugs; Orthopedics; Pain; Patients; Range of motion; Reconstruction; Rehabilitation; Surgery; Tendons - surgery; Trauma; Treatment Outcome; Triangular Fibrocartilage - diagnostic imaging; Triangular Fibrocartilage - surgery; Triangular fibrocartilage complex; Wrist; Wrist Injuries - diagnostic imaging; Wrist Injuries - surgery; Wrist Joint - diagnostic imaging; Wrist Joint - surgery; Young Adult; United States > US; Irreparable; Reconstruction; Wrist; Arthroscopy; Triangular fibrocartilage complex
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-021-02827-2

Tears 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. We 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. The 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. The 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.