Treatment of injury of the triangular fibrocartilage complex (TFCC)

Background. The triangular fibrocartilage complex (TFCC) supplies stability and cushioning for proper wrist function. TFCC lesions, a common cause of ulnar-sided wrist pain, can be traumatic (Palmer I) or degenerative (Palmer II) in nature. Clinical assessment is basic for making the diagnosis, but imaging may be helpful. Conservative treatment is the best choice for most acute cases. If the symptoms persist, however, operative treatment has a better prognosis for pain relief. Wrist arthroscopy has a major role to play in the diagnosis and treatment of TFCC lesions. Material and methods. 29 patients were operated in the Hand Surgery Department in Poznań due to TFCC lesions. 16 patients were qualified as Palmer type I (9 sport injuries, 7 sprains). while 13 patients had Palmer type II secondary to distal radial fractures. All patients suffered ulnar wrist pain and were positive on provocation tests. The indication for surgery was a lack of response to conservative treatment. Different operative procedures were used, depending on the type of lesion: arthroscopic debridement, open or arthroscopic restabilization of the TFCC, ulnar shortening, or partial resection of the ulnar head (Wafer). Rehabilitation was introduced following a period of immobilization. Results. Wrist pain was significantly diminished or disappeared after surgical treatment and rehabilitation. Conclusions. Good functional result and pain relief can be expected following surgical treatment of TFCC injuries.