Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures

The aim of this prospective study was to determine whether peripheral tears of the triangular fibrocartilage complex (TFCC) in patients younger than t he osteoporotic age (males, <60 years; females, <50 years) were related to chronic distal radioulnar joint (DRUJ) instability, Fifty-one patients (27 women) with displaced distal radial fractures were included in the study. T he med lan age was 41 years (range, 20-57 years). Arthroscopy at the ti me of fracture showed complete or partial TFCC tears in 43 patients (24 had on ly peripheral tears, 10 had only central perforations, and 9 had combined t ears). The 1-year (range, 11-27 months) follow-up period included an interv iew, physical examination, and radiographic evaluation. Ten of the 11 patie nts with complete peripheral TFCC tears had DRUJ instability at the follow- up examination compared with 7 of the 32 patients with only partial or no p eripheral tears. Patients with instability of the DRUJ had a worse Gartland and Werley wrist score. Instability was not associated with any radiograph ic finding either at the time of fracture or at the follow-up examination. Initial fracture or nonunion of the styloid was even slightly more common i n stable patients. (J Hand Surg 2000;25A:464-468, Copyright (C) 2000 by the American Society for Surgery of the Hand.).