ARTHROSCOPIC REPAIR OF PERIPHERAL AVULSIONS OF THE TRIANGULAR FIBROCARTILAGE COMPLEX OF THE WRIST - A MULTICENTER STUDY

A multicenter study to assess arthroscopic reconstruction of the perip heral attachment of the triangular fibrocartilage complex was undertak en. A total of 44 patients (45 wrists) from three institutions were re viewed. Twenty-seven of the 45 wrists had associated injuries, includi ng distal radius fracture (4), partial or complete rupture of the scap holunate (7), lunotriquetral (9), ulnocarpal (2), or radiocarpal (2) l igaments. There were two fractured ulnar styloids and one scapholunate accelerated collapse (SLAC) wrist deformity. The peripheral tears wer e repaired using a zone-specific repair kit. The patients were immobil ized in a munster cast, allowing elbow flexion and extension, but no p ronation or supination for 4 weeks, followed by 2 to 4 weeks in a shor t arm cast or VersaWrist splint. All patients were reexamined independ ently 1 to 3 years postoperatively by a physician, therapist, and regi stered nurse. The results were graded according to the Mayo modified w rist score. Twenty-nine of the 45 wrists were rated excellent, 12 good , 1 fair, and 3 poor. Overall, 42 of the 45 patients (93%) rated as sa tisfactory and returned to sports or work activities. One patient had chronic pain, and two patients had ulnar nerve symptoms, although moti on was normal in all, and their grip strength was at least 75% of the opposite hand. Arthroscopic repair of peripheral tears of the triangul ar fibrocartilage complex (TFCC) is a satisfactory method of repairing these injuries.