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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Matrix-assisted Autologous Chondrocyte Transplantation for Remodeling and Repair of Chondral Defects in a Rabbit Model
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All-Inside Versus Outside-in Repair of Triangular Fibrocartilage Complex Peripheral Tears.

Lilah Fones1, Keegan P Cole2, Moody Kwok1

  • 1Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.

The Journal of Hand Surgery
|June 24, 2023
PubMed
Summary
This summary is machine-generated.

Arthroscopic repair of triangular fibrocartilage complex (TFCC) peripheral tears using the all-inside technique offers outcomes comparable to the outside-in method. This approach demonstrates similar range of motion, grip strength, and functional recovery, with reduced immobilization time.

Keywords:
All-insideTFCC tearoutside-inulnar wrist painwrist arthroscopy

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Wrist Arthroscopy

Background:

  • Peripheral tears of the triangular fibrocartilage complex (TFCC) can cause persistent wrist pain.
  • Arthroscopic surgical repair is a viable treatment option due to the vascularity of the TFCC periphery.
  • Prior studies have established the safety and efficacy of all-inside TFCC repair.

Purpose of the Study:

  • To compare the outcomes of two arthroscopic peripheral TFCC repair techniques: all-inside vertical mattress and outside-in horizontal mattress.
  • To evaluate functional recovery, complications, and immobilization duration between the two surgical methods.

Main Methods:

  • Retrospective comparative study of patients undergoing arthroscopic TFCC repair for Palmer 1B tears between 2016 and 2021.
  • Exclusion criteria included ulnar extrinsic ligament repair, distal radioulnar joint instability, ulnar shortening osteotomy, and extensor carpi ulnaris instability.
  • Outcomes assessed included Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores, range of motion, grip strength, immobilization time, complications, and need for revision.

Main Results:

  • Fifty-two patients were analyzed (32 outside-in, 20 all-inside) with an average follow-up of 24.8 weeks.
  • Both groups showed similar improvements in range of motion and grip strength.
  • Postoperative QuickDASH scores improved significantly in both groups (outside-in: 47 to 13; all-inside: 50 to 9). Mean immobilization was 5.25 weeks for outside-in versus 2.0 weeks for all-inside.

Conclusions:

  • The all-inside arthroscopic peripheral TFCC repair technique yields results comparable to the outside-in technique.
  • Both methods demonstrate similar improvements in functional outcomes (QuickDASH scores), range of motion, and grip strength.
  • The all-inside technique is associated with a significantly shorter immobilization period.