Outcomes Following Early Active Wrist Mobilization Initiated 1 Week after TFCC Reinsertion: A Retrospective Study of 74 Patients

The mobilization regime after triangular fibrocartilage complex (TFCC) reinsertion is under debate, and there is no consensus in the literature. It would be desirable to mobilize patients more rapidly than traditional mobilization protocols; however, there are concerns regarding the risk of reinstability. During the last decade, our department developed and used a more accelerated rehabilitation protocol. The aim of this retrospective study was to evaluate the outcome and reinstability rate after TFCC reinsertion with this accelerated rehabilitation protocol. A total of 74 patients (30 women/44 men) operated with foveal reinsertion of the TFCC (63 mini-open surgery, 11 arthroscopic surgery), who underwent the accelerated rehabilitation protocol, were evaluated after 1 year for stability, range of motion (ROM), grip strength, pain and function, using Patient Satisfaction Functional Score (PSFS), Visual Analog Scale (VAS), Patient-Rated Wrist Evaluation (PRWE), as well as Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) and Satisfaction grade. One patient needed surgery due to reinstability. Seven patients were assessed as semi-unstable in one of three directions (four mini-open and three arthroscopic surgeries). Twenty-one patients had additional surgery at the index operation. There was a statistically significant improvement in grip strength, wrist flexion, PSFS, VAS, PRWE, and Quick-DASH scores. The median Satisfaction grade was 4 (very satisfied). Early mobilization with ROM exercises initiated 1 week after TFCC reinsertion results in high patient satisfaction, consistently good outcomes, and a low frequency of reinstability. III.