Arthroscopic treatment of degenerative tears of the triangular fibrocartilage

The arthroscope permits treatment of degenerative tears of the TFC and associated lesions. It lends itself to the assessment and treatment of both "primary" and "secondary" ulnar impaction syndromes. Ulnocarpal, radiocarpal, and midcarpal synovitis can be excised, as can partial tears of the lunatotriquetral interosseous ligament. The primum movens of the ulnar impaction syndrome, a long ulna, can be shortened arthroscopically if the positive ulnar variance is less than 4 mm and no distal radioulnar joint instability or degenerative changes are noted. Although an arthroscopic "wafer" procedure is possible, more clinical studies are needed to allow an accurate assessment of its efficacy.