A modified arthroscopic ulnar tunnel technique for foveal triangular fibrocartilage complex injury

Gvozdenovic, Robert; Simonsen, Sabine

doi:10.1080/2000656x.2022.2070179

Cited by 6 publications

(6 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our recent study 20 reported on 44 patients treated for a TFCC injury treated with fovea-only transosseous ulnar tunnel fixation. Patients improved notably in all clinical parameters and all patients ended in a stable DRUJ condition.…”

Section: Discussionmentioning

confidence: 99%

“…19 Before surgery, the patients were assessed clinically and radiographically, and 44 patients were excluded as their results were reported in our other study with foveal-only injuries. 20 The main inclusion criteria for this study were a positive fovea sign according to Tay et al 21 and a positive hook and trampoline test during the arthroscopic evaluation of TFCC injury ( Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…The modified ulnar tunnel operative technique is described in detail in the study of foveal-only injuries. 20 The original technique, developed by Iwasaki and Minami, 23 described drilling the osseous tunnel (2.9 mm in diameter) outside-in through the distal ulna, ending in the dorso-ulnar part of the TFCC complex. Single 2–0 nonabsorbable suture (Prolene, Ethicon, Somerville, NJ) was tied into the ulnar periosteum.…”

Section: Methodsmentioning

confidence: 99%

“…The wire, placed inside the SutureLasso Straight, is taken out of the joint through the 6 R arthroscopic portal using a grasper, fed with a FiberWire, and retrieved through the bony canal, without placement of a knot. 20 Two additional (2.5 mm in diameter and ∼10–13 mm in length) bony canals were then drilled proximally from the working tunnel in the ulna, preferably using the same, slightly proximally extended skin incision. They were used for placement of the final, knotless fixation in the ulna, under direct visualization, and, importantly, after loosening the tension of the traction tower.…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

A Modified Arthroscopic Ulnar Tunnel Technique for Combined Foveal and Capsular (All-Inside) Fixation of Triangular Fibrocartilage Complex Injury

Simonsen

Gvozdenovic

2023

J Wrist Surg

Self Cite

View full text Add to dashboard Cite

Background Traumatic disruption of the triangular fibrocartilage complex (TFCC) is commonly present in various wrist traumas. A variation of surgical techniques is previously developed for different injury patterns. To our knowledge, only a few studies have investigated the fixation of combined foveal and capsular TFCC injuries using the ulnar tunnel technique. Purpose This prospective cohort study of 21 patients aimed to evaluate the clinical and patient-reported outcome at 2 years of follow-up after arthroscopic TFCC of combined, foveal, and capsular reattachment by modified ulnar tunnel technique. Methods Pain, grip strength, wrist motion, inclusive rotation, and patient-reported outcomes were assessed pre- and postoperatively at 2 years of follow-up. Results No complications occurred preoperatively. Pain and patient-reported outcomes improved significantly (p < 0.0001 and 0.004). Grip strength improved, but not significantly (p = 0.088). The range of motion remained unchanged. All the patients achieved full stability of the distal radioulnar joint. Two patients sustained a new TFCC injury due to a wrist trauma and underwent a reoperation successfully. Two patients experienced complications: one patient experienced tenderness caused by cyst occurrence after PushLock ankers and the second had subluxation of the extensor carpi ulnaris tendon subsheet. Both patients were successfully treated and reoperated on with curettage of the cyst, and reconstruction of the extensor carpi ulnaris retinaculum. All the patients ended with good or excellent satisfaction scores. Conclusion The ulnar tunnel technique for combined foveal and capsular injuries shows promising short-term follow-up results and high satisfaction scores in the patients. Level of Evidence: II (Prospective Corhorte).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

A Modified Arthroscopic Ulnar Tunnel Technique for Combined Foveal and Capsular (All-Inside) Fixation of Triangular Fibrocartilage Complex Injury

Simonsen

Gvozdenovic

2023

J Wrist Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…Given the abundant peripheral blood supply of the TFCC, peripheral tears can potentially heal after a repair [4] and restore DRUJ stability. Previous studies have demonstrated that transosseous suture repair of TFCC foveal tears using various methods can restore DRUJ stability with satisfactory functional improvement [5][6][7][8][9]. According to Nakamura et al, the TFCC foveal insertion footprint is broad [10]; hence, multiple sutures or ligament-speci c repairs are required to achieve anatomical repair of the TFCC foveal tear [11,12].…”

Section: Introductionmentioning

confidence: 99%

Arthroscopically assisted repair of triangular fibrocartilage complex foveal tear using modified “double loop suture” – a retrospective cohort study

Zheng,

Zhao,

et al. 2024

Preprint

View full text Add to dashboard Cite

Background The triangular fibrocartilage complex (TFCC) plays an important role in the distal radioulnar joint (DRUJ)stabilization, and is frequently torn. Especially when conservative treatment fails, surgical treatment is required. Methods Fourteen individuals with TFCC foveal tear and DRUJ instability were admitted to the department and treated with arthroscopic-assisted modified “double loop suture” transosseous repair between January 2021 and 2023. During the surgery, an osseous tunnel was established, and two nickel-based alloy loops and a polydioxanone II (PDS II) suture were used to achieve the anatomic repair of the tear. All patients received supervised rehabilitation exercises after surgery. Results The patients were followed up for an average of 15.3 months. The mean Visual Analog Scale (VAS) score, grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) score before surgery were 4.7 points, 17.3 kg, and 35.2 points, respectively, compared with 1.9 points, 20.7 kg, and 15.5 points at the final follow-up, with significant differences. The median Patient-Rated Wrist Evaluation (PRWE) score was 27.50 before surgery, which then decreased to 10.00 at the final follow-up, with significant differences. The mean flexion-extension range of the wrist and pronation-supination range of the forearm, respectively, increased from 111 degrees and 125 degrees before surgery to 116 degrees and 135 degrees at the final follow-upassessment. None of the assessed individuals exhibited DRUJ instability or developed surgery-related complications. Conclusion Arthroscopic-assisted modified “double loop suture” is a secure and efficient approachfor achieving anatomic repair of TFCC foveal tears, with satisfactory functional improvement and restoration of DRUJ stability.

show abstract

Arthroscopic-Assisted Repair of the Triangular Fibrocartilage Complex

Zhou,

Tuyishime,

Yao

2024

Journal of Hand Surgery Global Online

View full text Add to dashboard Cite

A modified arthroscopic ulnar tunnel technique for foveal triangular fibrocartilage complex injury

Cited by 6 publications

References 26 publications

A Modified Arthroscopic Ulnar Tunnel Technique for Combined Foveal and Capsular (All-Inside) Fixation of Triangular Fibrocartilage Complex Injury

A Modified Arthroscopic Ulnar Tunnel Technique for Combined Foveal and Capsular (All-Inside) Fixation of Triangular Fibrocartilage Complex Injury

Arthroscopically assisted repair of triangular fibrocartilage complex foveal tear using modified “double loop suture” – a retrospective cohort study

Arthroscopic-Assisted Repair of the Triangular Fibrocartilage Complex

Contact Info

Product

Resources

About