Arthroscopic-assisted 6U approach for foveal reattachment of triangular fibrocartilage complex with an anchor: Clinical and radiographic outcomes at 4 years’ mean follow-up

Auzias, Pierre; Camus, Emmanuel; Moungondo, Fabian; Overstraeten, Luc Van

doi:10.1016/j.hansur.2020.01.001

Cited by 15 publications

(15 citation statements)

References 30 publications

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“…26,40,48 Fourteen studies reported peripheral TFCC repairs [26][27][28][29][30][31][32][33][34][35][36][37][38][39] and 13 studies reported foveal avulsions of the TFCC. [40][41][42][43][44][45][46][47][48][49][50][51][52] As the pathoanat-omy of these tears and repair techniques differ, the outcomes of peripheral and foveal tears were analyzed separately.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…The period before surgical repair was reported in 10 studies, and the average duration was 12.7 months. Foveal avulsions were reattached using either suture anchors (six studies, n ¼ 165) [41][42][43][47][48][49] or sutures through ulnar transosseous tunnels (seven studies, n ¼ 143). 41,47,48 This was performed via suture shuttles using an outside-in technique through a direct foveal portal.…”

Section: Repair Techniques and Pooled Analysis Of Outcome Measuresmentioning

confidence: 99%

“…All studies immobilized patients from a range of 3 to 8 weeks, using long arm or sugar tong splints, or cast, with some authors changing to a short arm cast or removable wrist splint after 2 to 4 weeks. [27][28][29]32,34,[39][40][41][42]45,47,49,52 Four studies immobilized the DRUJ with K-wires for 3 to 6 weeks after a peripheral repair. 26,29,33,47 Return to heavy activities and sport was at 3 to 6 months after surgery.…”

Section: Postoperative Immobilization and Rehabilitation (For Both Pementioning

confidence: 99%

“…In four papers, the DRUJ instability was noted to be mild in 14 of the 15 patients with this complication-being described as slightly looser than the contralateral side. 40,42,49,51 The remaining patient was reported to have moderate instability. 49 Five studies listed DRUJ instability as an exclusion criterion.…”

Section: Journal Of Wrist Surgerymentioning

confidence: 99%

“…45,47 Extensor digiti minimi irritation (2.7%, n ¼ 1) 28 and mild irritation surrounding suture knots (47.4%, n ¼ 9,) 46 were noted, and resolved without surgical intervention. Other complications included chronic regional pain syndrome (8.3%, n ¼ 2) 42 and hypertrophic scarring (2.5%, n ¼ 1). 38…”

Section: Soft Tissue Complicationsmentioning

confidence: 99%

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Surgical Repair of Triangular Fibrocartilage Complex Tears: A Systematic Review

et al. 2020

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Objective This study systematically reviews the outcomes of surgical repair of triangular fibrocartilage complex (TFCC) tears. Existing surgical techniques include capsular sutures, suture anchors, and transosseous sutures. However, there is still no consensus as to which is the most reliable method for ulnar-sided peripheral and foveal TFCC tears. Methods A systematic review of MEDLINE and EMBASE was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The focus was on traumatic Palmer 1B ulna-sided tears. Twenty-seven studies were included, including three comparative cohort studies. Results There was improvement in all functional outcome measures after repair of TFCC tears. The outcomes following peripheral and foveal repairs were good overall: Mayo Modified Wrist Evaluation (MMWE) score of 80.1 and 85.1, Disabilities of the Arm, Shoulder and Hand (DASH) score of 15.7 and 15.8, grip strength of 80.3 and 92.7% (of the nonoperated hand), and pain intensity score of 2.1 and 1.7, respectively. For peripheral tears, transosseous suture technique achieved better outcomes compared with capsular sutures in terms of grip strength, pain, Patient-Rated Wrist Evaluation (PRWE), and DASH scores (grip 85.8 vs. 77.7%; pain 1.5 vs. 2.2; PRWE 11.6 vs. 15.8; DASH 14.4 vs. 16.1). For foveal tears, transosseous sutures achieved overall better functional outcomes compared with suture anchors (MMWE 85.4 vs. 84.9, DASH 10.9 vs. 20.6, pain score 1.3 vs. 2.1), but did report slightly lower grip strength than the group with suture anchors (90.2 vs. 96.2%). Arthroscopic techniques achieved overall better outcomes compared with open repair technique. Conclusion Current evidence demonstrates that TFCC repair achieves good clinical outcomes, with low complication rates. Level of Evidence This is a Level IV therapeutic study.

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