ABSTRACT
Triangular fibrocartilage complex (TFCC) tears are a common source of ulnar sided wrist pain. Originally described by Palmer, in 1981, as a complex of several structures, our understanding of the anatomy and the function of the TFCC has been refined by histologic studies. The TFCC plays an important role in load bearing across the wrist as well as in distal radioulnar joint (DRUJ) stabilization. A thorough knowledge of the anatomy as well as the Palmer classification system helps to guide treatment options.
Subject(s)
Triangular Fibrocartilage/injuries , Arthroscopy , Biomechanical Phenomena , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Rupture , Triangular Fibrocartilage/surgery , Wrist Injuries/diagnosis , Wrist Injuries/physiopathologyABSTRACT
Insulin-dependent diabetes mellitus is associated with shoulder stiffness and a propensity toward postoperative wound complications and infection. We compared our results of open repair of full-thickness rotator cuff tears in 30 diabetic patients with those of a matched, nondiabetic population. No differences were observed in preoperative range of motion, although at a mean of 34 months, significant differences in shoulder active range of motion and passive range of motion were found postoperatively at 6 weeks, 6 months, and final follow-up (P <.05). On the basis of American Shoulder and Elbow Surgeons shoulder scoring, there were 27 (90%) and 28 (93%) good or excellent results in the diabetic and comparison groups, respectively. Complications occurred in 5 diabetic patients (17%), with 2 failures (7%) and 3 infections (10%), as compared with 1 failure (3%) and no infections in the comparison group. Repair of the diabetic rotator cuff may be performed with the expectation of improved motion and function, although less than nondiabetic counterparts. The surgeon should remain cognizant that a higher rate of complications, infection in particular, may occur after rotator cuff repair in the diabetic population.
Subject(s)
Diabetes Mellitus, Type 1 , Rotator Cuff Injuries , Rotator Cuff/surgery , Adult , Aged , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/physiopathology , Female , Humans , Male , Middle Aged , Postoperative Complications , Range of Motion, Articular , Rotator Cuff/physiopathology , Shoulder Joint/physiopathologyABSTRACT
Thermal energy in arthroscopic surgery needs further follow-up evaluation to clarify the potential benefits, specifically with respect to thermal shrinkage. Although the initial findings are promising, the long-term results need to be compared with other accepted standards of management. Preliminary findings seem to show that the addition of these surgical instruments and expanding operative techniques have definite roles in arthroscopic wrist surgery, as demonstrated through meticulous synovectomies and precise tissue debridement, along with the possible thermal shrinkage potential.
