• T Pillukat, R A Fuhrmann, J Windolf, and J van Schoonhoven.
• Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland. t.pillukat@handchirurgie.de.
• Oper Orthop Traumatol. 2016 Aug 1; 28 (4): 233-50.

ObjectiveRefixation of the triangular fibrocartilage complex (TFCC) to the ulnar capsule of the wrist.IndicationsDistal TFCC tears without instability, proximal TFCC intact. Loose ulnar TFCC attachment without tear or instability.ContraindicationsPeripheral TFCC tears with instability of the distal radioulnar joint (DRUJ). Complex or proximal tears of the TFCC. Isolated, central degenerative tears without healing potential.Surgical TechniqueArthroscopically guided, minimally invasive suture of the TFCC to the base of the sixth extensor compartment.Postoperative ManagementAbove elbow plaster splint, 70° flexion of the elbow joint, 45° supination for 6 weeks. Skin suture removal after 2 weeks. No physiotherapy to extend pronation and supination during the first 3 months.ResultsIn an ongoing long-term study, 7 of 31 patients who underwent transcapsular refixation of the TFCC between 1 January 2003 and 31 December 2010 were evaluated after an average follow-up interval of 116 ± 34 months (range 68-152 months). All patients demonstrated an almost nearly unrestricted range of wrist motion and grip strength compared to the unaffected side. All distal radioulnar joints were stable. On the visual analogue scale (VAS 0-10), pain at rest was 1 ± 1 (range 0-2) and pain during exercise 2 ± 2 (range 0-5); the DASH score averaged 10 ± 14 points (range 0-39 points). All patients were satisfied. The modified Mayo wrist score showed four excellent, two good, and one fair result. These results correspond to the results of other series.ConclusionTranscapsular refixation is a reliable, technically simple procedure in cases with ulnar-sided TFCC tears without instability leading to good results.

26 keywords...

hide…