Related Experiment Video
Updated: Dec 10, 2025

Novel Triple-Loop Technique for Suturing TFCC Injuries without Transosseous Tunnel
Published on: May 23, 2025
Single-strand repair of EWAS 1 lesion of triangular fibrocartilage complex
Ramy Ahmed Soliman1, Mohamed Mostafa El-Mahy2, Ahmed Naeem Atiyya2
1Orthopedic Surgery, Ain Shams Univeristy, 13 B Kornish El Nile, Agha Khan, Cairo, 0020, Egypt. ramy.diab@med.asu.edu.eg.
Purpose:
To report the results of our modified technique for repair of the EWAS 1 lesion of triangular fibrocartilage complex (TFCC).
Methods:
This retrospective case series reviewed 22 consecutive patients with EWAS 1 TFCC tear. Arthroscopic repair was done using our modified double-loop arthroscopic outside-in technique which is originally described by Mathoulin and Del Piñal. The repair was performed using single-strand suture and 18-gauge cannula, having three passes through the tear. Follow-ups ranged from 24 to 33 months with an average of 29.3 months. The results were evaluated by the Modified Mayo Wrist Score (MMWS), Visual Analog Score (VAS). In addition, range of motion (ROM) and power grip were compared with the contralateral side.
Results:
The mean age was 23 years. The dominant side was affected in 16 wrists. There was postoperative improvement of the all functional outcome measures (MMWS, VAS, ROM, and power grip). All the patients returned to their previous activities with no reported intra- or postoperative complications.
Conclusions:
The described outside-in technique is safe and effective technique for repair of EWAS 1 TFCC tear.
Level Of Evidence:
Therapeutic, case series, level IV.
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