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

Concealed TFCC Tears Revealed- Role of Wrist Arthroscopy in the Diagnosis and Treatment of Occult Chronic TFCC Injury

Meeting Abstract

  • presenting/speaker Abhijeet Wahegaonkar - Sancheti Institute for Orthopedics & Rehabilitation, Jehangir Hospital, Pune, India
  • Chaitanya Karande Patil - The Hand Surgery Clinics, Sahyadri Hospital, Pune, India
  • Anup Bansode - The Hand Surgery Clinics, Sahyadri Hospital, Pune, India
  • Satish Mane - The Hand Surgery Clinics, Sahyadri Hospital, Pune, India

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. DocIFSSH19-1906

doi: 10.3205/19ifssh0828, urn:nbn:de:0183-19ifssh08288

Published: February 6, 2020

© 2020 Wahegaonkar et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: The triangular fibrocartilage complex (TFCC) is an important stabilizer and load absorber in the wrist. There is a significant load borne by the ulnar aspect of the wrist during different wrist positions that pass predominantly through the TFCC. Injury to the TFCC is a frequent cause of pain and disability in the wrist. Good results have been reported with open repair. Advances in wrist arthroscopy have enabled these lesions to be repaired by minimally invasive methods. Arthroscopic repair of peripheral TFCC tears can provide satisfactory results with significant pain relief, increased grip strength, and an increased capacity to perform daily activities.

There is a large cohort of patients with an acute on chronic type of TFCC injury, who are clinically diagnosed with a TFCC tear with or without DRUJ instability, however the MRI is often unequivocal. We believe that this is due to scar formation in the injury zone that masks the lesion on an MRI. Arthroscopic examination and shaving of the scar tissue reveals the tear and allows optimal treatment of the lesion.

Methods: In this paper we describe our experience of 25 cases with chronic TFCC injury and an unequivocal MRI report. Arthroscopic evaluation and shaving followed by repair was performed. All patients were followed up for a minimum of 12 months. ROM, grip strength, pain scores and DRUJ stability were measured for outcomes measures.

Results and Conclusions: All patients had a significant improvement in their post-operative average Mayo Wrist Scores as compared to the pre-operative scores.

Arthroscopy of the wrist is considered the "gold standard" for evaluating and treating many intra-articular wrist conditions, such as triangular fibrocartilage complex tears, chondral injuries, distal radius fractures, carpal fractures, wrist ligament injuries, loose bodies, and ganglia. However, a thorough knowledge of wrist anatomy and surface landmarks is essential to proper diagnosis and treatment.