Arthroscopic Tendon Graft to Reconstruct the Foveal Insertion of the Triangular Fibrocartilage and Repair of the Dorsal Peripheral Tear of the Triangular Fibrocartilage

While tendon graft augmentation for severe triangular fibrocartilage complex (TFCC) tears has been described using different techniques, the indications, tear definitions, and clinical outcomes remain inconsistently reported. This study presents a novel tendon graft repair that reconstructs the foveal ligament and corrects the radial displacement of the TFCC and evaluates its clinical outcomes. A retrospective review of 11 patients who had a tendon graft procedure performed over a 6-year period was performed. The anatomy of the tear and the integrity of the foveal ligament were defined by dry arthroscopy of the distal radioulnar joint (DRUJ). Preoperative and postoperative measurements were compared. There was a 30 kg improvement in both pronation and supination strength. A total of 10 of the 11 patients had other pathologies in the wrist, which were arthroscopically repaired during the same procedure. One minor complication was reported. The unique tendon graft technique described in this study appears effective in treating severe tears of the TFCC. This is the first study to report on pronation and supination strength postoperatively and define the anatomy of the tear as identified using dry arthroscopy of the DRUJ.