gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

All-through 6R single portal repair of superficial TFCC tear

Meeting Abstract

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  • presenting/speaker Mostafa Mahmoud - Cairo University, Cairo, Egypt

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1754

doi: 10.3205/19ifssh0831, urn:nbn:de:0183-19ifssh08317

Veröffentlicht: 6. Februar 2020

© 2020 Mahmoud.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives/Interrogation: Many repair techniques were described for the traumatic superficial peripheral TFCC tear (Palmer type 1B or European Wrist Arthroscopy Society (EWAS) Atzei type 1). Most outside in techniques report 6U or DRUJ portal in addition to the 6R portal as working portals to achieve a secure repair. We used the 6R as a single portal for repairing such tears and evaluated the results of this technique in 28 patients.

Methods: We repaired the TFCC in 28 patients following arthroscopic confirmation of the tear using two or three vertical mattress 2/0 PDS sutures tied through 6R portal after its hypodermic insertion 1 cm proximal to it. We included patients with traumatic ulnar side wrist pain with positive foveal sign who failed conservative management and rehabilitation for at least three months. We excluded patients with previous distal radius fracture, DRUJ instability, radiographic ulna plus variance, arthroscopic diffuse synovitis, cartilage degeneration or complex TFCC tear. The mean age of the patients was 32y (range from 18 to 45). They were 26 males and 2 females.

Dominant side was affected in 19 patients. Sixteen patients only reported traumatic event with acute pain due to twisting injury (n=6) or a fall on a pronated hand (n=10) while the other 12 reported gradual onset of the pain with no considerable trauma.

Results and Conclusions: The mean follow up period was 39 months (16-66). There was statistically significant (p < 0.05) improvement of the mean post-operative VAS for pain from 4.8 (3.5-6) to 1.3 (0-4.5) and QDASH from 31.5 (27.3-40.9) to 9.2 (6.8-15.9). Twenty-six patients returned to their pre injury level of activity, one patient needed revision surgery after 12 months pain free period and found to have complex tear and the last patient stopped his recreational activity because of post activity pain. No irritation of superficial nerves reported and we did not need to remove the PDS stitches in any patient.

In conclusion, Single 6R portal repair of the traumatic superficial TFCC tear is possible and effective method of management.