Arthroscopic repair of isolated triangular fibrocartilage complex tears

ABSTRACT

A prospective study included 22 patients with a symptomatic triangular A. JL Jibrocartilage tear [Palmer's type IB or type 1C]. Pre-operative clinical diagnosis was confirmed by conventional MRI, MRI arthrogram and arthroscopically. All cases were arthroscopically repaired using the two needle technique. The mean follow-up period was 26 [range, 11 to 48] months. Pre-operatively, all patients complained of pain, restricted wrist and forearm motion and weakness of hand grip. According to the used El-Hadra wrist function scoring system, the mean pre-operative score was 9 [range, 4 to 12] points that improved after surgery to a mean of 20 [range, 16 to24] points, with thirteen wrists were graded excellent, eight good and one as fair. Pain was relieved completely in 15 wrists. Eighteen patients gradually returned to their original jobs and sports activities. The mean objective range of wrist movements increased to 91% of that of the normal side and the mean grip strength improved to 83% of the unaffected side. The results are encouraging and the procedure would seem to be an effective treatment for Palmer's types IB and 1C TFCC tears. It is also a less invasive option of management that may have mechanical advantages of stabilizing the ulnocarpal articulation and the distal radioulnar joint, while significantly improving the clinical symptoms