Arthroscopic Triangular Fibrocartilage Complex Reconstruction Using a Palmaris Longus Tendon Graft

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Wrist Arthroscopy

Background:

• Chronic triangular fibrocartilage complex (TFCC) foveal tears cause persistent ulnar wrist pain and distal radioulnar joint instability.
• Current treatments for TFCC foveal tears often involve reconstruction, but minimally invasive options are sought.

Purpose of the Study:

• To describe and evaluate an arthroscopic TFCC reconstruction technique using a palmaris longus tendon graft for chronic foveal tears.
• To assess the feasibility and indications of this minimally invasive approach.

Main Methods:

• Arthroscopic TFCC reconstruction performed using a palmaris longus tendon graft.
• A bone tunnel was created in the ulna from the ulnar shaft to the fovea.
• Graft passed through TFCC remnants and ulnar bone tunnel, fixed with an interference screw.

Main Results:

• The technique is indicated for TFCC foveal tears with intact radial-side remnants.
• Contraindicated if radial-side tear and instability coexist, requiring broader TFCC stabilization.
• The arthroscopic approach preserves surrounding structures and stabilizes the ulnar carpal complex.

Conclusions:

• Arthroscopic TFCC reconstruction with a palmaris longus graft is a viable, minimally invasive option for chronic foveal tears.
• Careful patient selection based on the integrity of the radial-side TFCC is crucial for successful outcomes.
• This technique offers effective stabilization of the ulnar carpal complex without disrupting adjacent anatomical structures.