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. 2018 Sep;7(4):292-297.
doi: 10.1055/s-0038-1641720. Epub 2018 Apr 10.

Midterm Results after Open versus Arthroscopic Transosseous Repair for Foveal Tears of the Triangular Fibrocartilage Complex

Yukio Abe  1 , Kenzo Fujii  1 , Takeyoshi Fujisawa  1
Affiliations

Midterm Results after Open versus Arthroscopic Transosseous Repair for Foveal Tears of the Triangular Fibrocartilage Complex

Yukio Abe et al. J Wrist Surg. 2018 Sep.

Abstract

Purpose Various surgical procedures for foveal tears of the triangular fibrocartilage complex (TFCC) have been reported, and the procedures can be grossly divided into open and arthroscopic repair. The surgical results of both procedures were compared. Materials and Methods Twenty-nine patients underwent repair of a TFCC foveal tear. The 13 men and 16 women were in the age range of 14 to 72 years (average age, 30 years). Five patients had a history of distal radius fractures that healed uneventfully with nonoperative treatment. The mean duration of symptoms before surgery was 7.1 months. The procedure for repair consisted of 8 open repairs and 21 arthroscopic repairs. In both procedures, the TFCC was repaired transosseously to the ulna. The mean follow-up period was 34.4 (range, 24-70) months. The patients' pain, range of motion (ROM), grasping power, ulnar head instability, Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), and Mayo modified wrist score (MMWS) were evaluated. The operating time was also compared. Results There were no significant differences between the groups in pain, ROM, grasping power, ulnar head instability, and DASH. The MMWS was excellent in 8 patients in the open repair group, with 18 excellent and 3 good in the arthroscopic repair group. The mean operating time was significantly shorter for arthroscopic repair than for open repair. Conclusion Satisfactory outcomes were achieved for both open and arthroscopic repair techniques in the midterm. If a surgeon becomes familiar with the arthroscopic repair, the arthroscopic technique would be more feasible than the open repair in terms of technical facility and shortening of the operating time. Level of Evidence Level III, therapeutic study.

Keywords: arthroscopy; fovea; triangular fibrocartilage complex; wrist.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
Distal radioulnar joint (DRUJ) arthroscopy for the left wrist showed complete tear of the fovea ( A ). DRUJ arthroscopy for the right wrist represented the elongated ligament without tension ( B ).
Fig. 2
Fig. 2
The open approach. The suture passes through the two bone tunnels with open approach.
Fig. 3
Fig. 3
The arthroscopic approach. The two loop sutures passed through the bone tunnels are retrieved through the 4–5 portal ( A ), the triangular fibrocartilage complex (TFCC) is tightly attached to the fovea with tying up the thread ( B ).
See this image and copyright information in PMC

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