Arthroscopic delayed repair of residual triangular fibrocartilage complex (TFCC) peripheral tears from distal radial fractures

Abstract Objective Residual triangular fibrocartilage complex (TFCC) peripheral tears is one of causes of chronic persistent ulnar wrist pain following distal radius fractures. The purpose of this study was to evaluate the application of diagnostic wrist arthroscopy in this condition and to access the clinical outcomes of arthroscopic delayed repair of residual TFCC peripheral tears from distal radial fractures. Methods Eight patients who underwent arthroscopic delayed repair of residual TFCC peripheral tears from distal radial fractures were retrospectively analyzed. The torn TFCC of all patients was repaired with arthroscopic trans-osseous or trans-capsular outside-in technique. Postoperative outcomes were evaluated using wrist range of motion (ROM), grip, Visual Analog Scale (VAS) score for pain in activity, Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and surgery-related complications. Results The mean duration from injury to TFCC repair was 11.6 months. The mean follow-up was 25.5 months. At arthroscopy, TFCC dorsal capsule attachment tear was found in 3 patients, Atzei class 1 disruption in 2 patients and Atzei class 2 avulsion in 3 patients. TFCC Palmer 1D injury was found in Atzei 1 class tear case and Atzei 2 class tear case. At the final follow-up, all outcomes were significantly improved except the radial and ulnar deviation. All patients had negative ballottement test and no surgery-related complications were found. Conclusion Arthroscopic delayed repair of residual TFCC peripheral tears from distal radial fractures is effective for those shown no evidence of degeneration and ulnar impaction arthroscopically and their preoperative time less than 16 months.