Outcomes of surgically treated distal radial fractures with associated triangular fibrocartilage complex injury

Prospective cohort.

Clinical studies that evaluate the correlation between associated lesions of the triangular fibrocartilage complex (TFCC) and outcome of distal radial fractures expressed with the patient-rated disability are missing.

To evaluate the outcomes of distal radius fractures associated with or without an injury of the TFCC.

Patients undergoing operative treatment for distal radial fracture were prospectively enrolled (n = 70). The TFCC was examined by wrist arthroscopy, and injuries were classified according to Palmer. Comparative analyses were performed on data from 45 patients with TFCC injury (the injured group) and 25 patients with an intact TFCC (the intact group). The outcome measures included The Patient-Rated Wrist Evaluation (PRWE) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires, 3 and 12 months after injury.

The TFCC was injured in 45 patients (64%). In patients with an intact TFCC, the mean total PRWE score was 27 (at 3 months) and 16 (at 12 months), whereas in patients with TFCC injury, it was 40 (at 3 months) and 24 (at 12 months). Mean DASH scores were 26 and 13 for the intact group and 39 and 27 for the injured group at 3 and 12 months, respectively. PRWE and DASH results showed significant difference at 3 and 12 months when compared using the Mann-Whitney test.

Disability outcomes were worse in patients with distal radial fracture where TFCC was injured. TFCC injuries are an important cofactor affecting the outcome of distal radial fractures.