TY - JOUR
T1 - A modified arthroscopic ulnar tunnel technique for foveal triangular fibrocartilage complex injury
AU - Gvozdenovic, Robert
AU - Hessler Simonsen, Sabine
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - Arthroscopically assisted techniques for the treatment of foveal triangular fibrocartilage complex (TFCC) injuries offer a less invasive option. Reports of the ulnar tunnel technique on a larger patient population are needed. This prospective cohort study of 44 patients aimed to evaluate the clinical and patient-reported outcome after arthroscopic foveal re-attachment using a novel, modified ulnar tunnel technique. Furthermore, preoperative magnetic resonance imaging findings were compared with the findings from the arthroscopic evaluation. History of ulnar sided wrist pain, positive fovea-sign at the clinical examination and positive hook test at the surgery were the main inclusion criteria for the study. Pain, grip strength, wrist motion and patient-reported outcomes were assessed pre-and postoperatively. The follow-up of this study was 31 months (range 18–48). No complications occurred during the surgery. All outcomes improved besides the range of motion, which remained unchanged. Pain on a visual analogue scale was 63 before, and 14 after the surgery (p =.0004). Pre- and postoperative values of Disability of Arm, Shoulder and Hand Questionnaire were 41/6, respectively (p =.007). Grip strength, measured in Kilogram-force were 29 and 36, pre-and postoperatively (p =.0004). Conspicuously, all patients achieved stability. Six patients needed re-operation, three for renewed injury. Thirty-nine of 44 patients scored excellent or good on the satisfaction score. We found the devised method to be with fewer complications and with favourable results compared with other techniques for the treatment of TFCC injuries. Level of evidence: III.
AB - Arthroscopically assisted techniques for the treatment of foveal triangular fibrocartilage complex (TFCC) injuries offer a less invasive option. Reports of the ulnar tunnel technique on a larger patient population are needed. This prospective cohort study of 44 patients aimed to evaluate the clinical and patient-reported outcome after arthroscopic foveal re-attachment using a novel, modified ulnar tunnel technique. Furthermore, preoperative magnetic resonance imaging findings were compared with the findings from the arthroscopic evaluation. History of ulnar sided wrist pain, positive fovea-sign at the clinical examination and positive hook test at the surgery were the main inclusion criteria for the study. Pain, grip strength, wrist motion and patient-reported outcomes were assessed pre-and postoperatively. The follow-up of this study was 31 months (range 18–48). No complications occurred during the surgery. All outcomes improved besides the range of motion, which remained unchanged. Pain on a visual analogue scale was 63 before, and 14 after the surgery (p =.0004). Pre- and postoperative values of Disability of Arm, Shoulder and Hand Questionnaire were 41/6, respectively (p =.007). Grip strength, measured in Kilogram-force were 29 and 36, pre-and postoperatively (p =.0004). Conspicuously, all patients achieved stability. Six patients needed re-operation, three for renewed injury. Thirty-nine of 44 patients scored excellent or good on the satisfaction score. We found the devised method to be with fewer complications and with favourable results compared with other techniques for the treatment of TFCC injuries. Level of evidence: III.
KW - Atzei III injury
KW - DRUJ
KW - fovea injury
KW - Palmer 1B injury
KW - proximal TFCC
KW - TFCC
KW - Triangular fibrocartilage complex
KW - Prospective Studies
KW - Humans
KW - Wrist
KW - Wrist Injuries/diagnostic imaging
KW - Pain
KW - Triangular Fibrocartilage/surgery
KW - Retrospective Studies
UR - http://www.scopus.com/inward/record.url?scp=85130192436&partnerID=8YFLogxK
U2 - 10.1080/2000656X.2022.2070179
DO - 10.1080/2000656X.2022.2070179
M3 - Journal article
C2 - 35533690
AN - SCOPUS:85130192436
VL - 57
SP - 308
EP - 314
JO - Journal of Plastic Surgery and Hand Surgery
JF - Journal of Plastic Surgery and Hand Surgery
SN - 2000-656X
IS - 1-6
ER -