Early isolated triangular fibrocartilage complex tears: management by arthroscopic repair

Tears in the traumatic triangular fibrocartilage complex (TFCC) are generally caused by falling accidents with pronated, hyperextended wrists, or by distraction injuries that pull the ulnar side of the wrist out of place. Tears in the triangular fibrocartilage complex often appear in association with ulnar wrist pain and limited wrist function in work or sport. This study addressed the arthroscopic repair of peripheral tears in the TFCC, in a sample of 37 patients who were undergoing TFCC repair by wrist arthroscopy.

From September 1996 to February 1999, 37 patients underwent TFCC repair by wrist arthroscopy. The mean follow-up period was 25.6 months (range, 22-28 months), and the patients' average age was 21 years. The study included 30 men and 7 women. All patients had early peripheral TFCC tears and no wrist fractures. The inside-out method was used to repair the tears and the distal radioulnar joint was fixed for 6 weeks using a 2.0-mm Kirschner wire. After operation, patients were rehabilitated, reexamined, and followed up at the clinic. Complications were also recorded.

The results were graded with a Mayo Modified Wrist Score. Ten of the 37 wrists were rated excellent, 24 were good, and 3 were fair. Overall, 34 of 37 patients (92%) rated satisfactorily and returned to sporting or work activities. Four patients experienced mild pain during work or exercise. Although motion remained normal for these patients, grip strength on the affected hand was at least 72% of that on the other hand.

Arthroscopic repair of early peripheral tears of the triangular fibrocartilage complex is a satisfactory method of repair. The procedure can enhance patients' wrist function by relieving pain and increasing tolerance for work or sport.