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· DOS Abstracts
Management of TFCC injuries – short term results of
foveal re-attachment by ulnar tunnel technique
Robert Gvozdenovic
Ortopaedic Surgery Department, Hand Surgery Unit, Herlev/Gentofte Hospital
Background:
Today, the most common cause of prolonged pain and disabil-
ity after distal radius fracture is ulnar-sided wrist pain. Triangular fibrocartilage
complex (TFCC) injury is present in up to 80 % of patients with displaced DRF.
Purpose / Aim of Study:
We report first experiences with our preferred meth-
od of foveal repair in TFCC reconstruction.
Materials and Methods:
Between April 2013 and June 2016, 10 patients
have been operated arthroscopically, by modified ulnar tunnel technique for fo-
veal re-attachment of TFCC injury. All patients had ulnar sided wrist pain and
MR verified foveal TFCC injury. All patients had some grade of instability of the
Distal Radioulnar Joint (DRUJ) and a positive hook test. Average time from the
injury to the reconstruction was 23 months (3–96 m). There were 4 men and
6 women with a mean age of 24 years (16 – 40y). All patients were immobi-
lized for 3 weeks. Mean follow-up was 24 months (12–48m). Retrospective
evaluation included assessment of pain (VAS score), satisfaction, DRUJ instabil-
ity, range of motion (ROM), grip strength and Disabilities of the Arm, Shoulder
and Hand (quick- DASH) Score.
Findings / Results:
No complication during the operative procedures or the
post-op period was seen. All patients but one achieved full stability and showed
improvement at the evaluation as well as full satisfaction. Both grip strength,
pain and q-DASH values improved significantly (p<0.05). Mean grip strength of
the operated hands showed a 23 % increase after the operative treatment (95
% of strength of the contralateral side). ROM improved, especially in pronation
and supination. In one case, we observed recurrent pain and instability of the
DRUJ.
Conclusions:
Preliminary results of foveal repair of the TFCC injury provided
satisfactory results with a few observed complications. The presented knotless
technique simplifies the procedure.
No conflicts of interest reported
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