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Jonny K Andersson, Martina Åhlén, Daniel Andernord
BACKGROUND AND PURPOSE: To investigate the outcome of open versus arthroscopic repair of injuries of the triangular fibrocartilage complex (TFCC). METHODS: An electronic literature search of articles published between January 1, 1985, and May 26, 2016, in PubMed, Embase, and the Cochrane Library was carried out in May 2016 and updated in March and December 2017. Studies comparing open and arthroscopic repair of TFCC injury with a mean follow up of more than 1 year were eligible for inclusion...
March 13, 2018: Journal of Experimental Orthopaedics
S Löw, C K Spies, F Unglaub, J Oppermann, M Langer, H Erne
BACKGROUND: The triangular fibrocartilage complex (TFCC) widens the radiocarpal joint and takes part in load transmission from the carpus to the forearm. It is thereby prone to degenerative changes. The painful situation that can accompany degeneration is called ulnar impaction. DIAGNOSIS: Clinical examination helps differentiate between various causes of ulnar-sided wrist pain. Standard X‑rays are needed to determine ulnar variance and stress radiographs can depict narrowing of the ulnocarpal joint space under load...
March 9, 2018: Der Orthopäde
Ji Hun Park, Dongmin Kim, Heesu Park, Inwon Jung, Inchan Youn, Jong Woong Park
PURPOSE: This study examined the influence of triangular fibrocartilage complex (TFCC) deep fiber tears on wrist proprioception. METHODS: The study involved 48 subjects: 24 with deep fiber TFCC tears and 24 with healthy wrists. A specially created sensor measured wrist proprioception in 3 axes of movement. Absolute differences between target and subject-reproduced angles were compared in injured and healthy wrists and in injured and contralateral patient wrists...
March 6, 2018: Journal of Hand Surgery
A Arsalan-Werner, L Grüter, I M Mehling, W Moll, O Wölfle, M Sauerbier
INTRODUCTION: Injuries of the triangular fibrocartilage complex (TFCC) are of high clinical relevance; however, the clinical evidence for treatment is poor and long-term results are rarely published. The purpose of this study was to evaluate the clinical outcome of symptomatic central traumatic lesions of the TFCC (Palmer 1A) following arthroscopic debridement. MATERIALS AND METHODS: Between 2007 and 2013, 87 patients were arthroscopically diagnosed with Palmer 1A lesion and accordingly treated with debridement...
March 5, 2018: Archives of Orthopaedic and Trauma Surgery
Hai-Jing Zhang, Rong-Chang Chen, Gui-Bo Sun, Long-Po Yang, Yin-di Zhu, Xu-Dong Xu, Xiao-Bo Sun
BACKGROUND: Clinopodium chinense (Benth.) O. Ktze is a traditional Chinese herbal medicine, which comprises the plant's total flavonoids. TFCC plays an important role in the treatment of cardiovascular disease. PURPOSE: The aim of the study was to study the protective effects and possible mechanism of TFCC against isoproterenol (ISO)-mediated myocardial injury in vivo and anoxia/reoxygenation (A/R)-induced H9c2 cell injury in vitro. METHODS: Male Sprague-Dawley (SD) rats were intragastrically pretreated with TFCC for 15 days...
February 1, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
Margaret Woon Man Fok, Christian Xinshuo Fang, Tak Wing Lau, Yin Keung Eric Fung, Boris Kwok Keung Fung, Frankie Ka Li Leung
PURPOSE: Distal radius fractures are associated with a high incidence of triangular fibrocartilage complex (TFCC) tears. This study aims to evaluate the status of TFCC after the healing of distal radius fractures, and its clinical significance. METHODS: Wrist arthroscopies were performed on 43 distal radius fractures, with an average age of 54 years old. RESULTS: Twenty-six complete tears and 15 partial healed tears were noted. Five out of eight patients with intact TFCC tears had neither signs nor symptoms, while eight patients with TFCC tears had no complaint...
February 23, 2018: International Orthopaedics
Samir K Trehan, Lindley B Wall, Ryan P Calfee, Tony S Shen, Christopher J Dy, Sarah M Yannascoli, Charles A Goldfarb
PURPOSE: To determine whether the arthroscopic hook and trampoline tests are accurate and reliable diagnostic tests for foveal triangular fibrocartilage complex (TFCC) detachment. METHODS: Wrist arthroscopy was performed on 10 cadaveric upper extremities. Arthroscopic hook and trampoline tests were performed and videos recorded (baseline). The deep foveal TFCC insertion was then sharply detached. Arthroscopic hook and trampoline tests were repeated. Subsequently, the foveal detachment was repaired via an ulnar tunnel technique and the hook test was repeated for a third time...
January 25, 2018: Journal of Hand Surgery
Sebastian Farr, Marion Schüller, Rudolf Ganger, Werner Girsch
Background  To the best of our knowledge, we are not aware of any reports focusing on results of arthroscopic debridement of triangular fibrocartilage complex (TFCC) tears in immature patients. Purpose  The purpose of this study was to evaluate our results after arthroscopic debridement of TFCC tears in adolescents. Materials and Methods  We retrospectively identified all patients of 18 years or less, who received an arthroscopic TFCC debridement due to a traumatic or degenerative tear according to Palmer...
February 2018: Journal of Wrist Surgery
Maysara Abdelhalim Bayoumy, Amr El-Sayed, Hesham A Elkady, Waleed Reyad Saleh, Hatem G Said, Abdelaziz M Ali
Triangular fibrocartilage complex (TFCC) injuries are increasingly recognized as a cause of ulnar-sided wrist pain. Palmer grouped these tears into either traumatic or degenerative, with various subclassifications. Magnetic resonance imaging (MRI), arthrogram, and arthroscopy are the methods used to establish the diagnosis. Several arthroscopic methods of TFCC repair including outside-in, inside-out, and all-inside techniques have been described. The outside-in repair, which involves piercing the TFCC via the ulnar side of the wrist, has been described by several authors, but the technique varies among authors with respect to instrumentation and subtle surgical modifications...
October 2017: Arthroscopy Techniques
Jayson C Johnson, Ferris M Pfeiffer, Jill E Jouret, David M Brogan
BACKGROUND: This study compares the effectiveness of a peripheral capsular repair with a knotless arthroscopic transosseous ulnar tunnel repair (TR) in restoring distal radioulnar joint (DRUJ) stability and stiffness in the setting of a massive triangular fibrocartilage complex (TFCC) tear. METHODS: Eight matched pairs of fresh-frozen cadaveric forearms were tested. Each forearm was tested in supination and pronation using 3-dimensional (3D) optical tracking devices prior to any intervention...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Sun Hwa Lee, Seong Jong Yun
OBJECTIVE: We evaluated the effectiveness of point-of-care wrist ultrasonography compared with 3T-magnetic resonance imaging (MRI) for diagnosing triangular fibrocartilage complex (TFCC) injuries in trauma patients with ulnar-sided pain and instability. Moreover, we assessed the inter-observer variability between an emergency physician and a musculoskeletal radiology fellow. MATERIAL AND METHODS: A prospective cross-sectional study was conducted in an emergency department; patients with ulnar-sided sprain and instability were recruited...
January 4, 2018: American Journal of Emergency Medicine
Maria Moloney, Simon Farnebo, Lars Adolfsson
The aims of this study were to investigate the functional result and rate of osteoarthritis 15-25 years after a TFCC-repair. Forty-seven patients completed the questionnaire Patient Rated Wrist Evaluation (PRWE), and 43 had new X-rays. Fifty-seven percent had a simultaneous arthroscopy. Sixteen patients had later additional surgery to the wrist, of these eight had a reoperation of the TFCC-injury due to recurrent instability. Radiographs showed that 17.5% had developed radiocarpal osteoarthritis and 34% osteoarthritis in the distal radioulnar joint...
December 19, 2017: Journal of Plastic Surgery and Hand Surgery
Ji Hun Park, Dongmin Kim, Jong Woong Park
PURPOSE: Arthroscopic repair of a peripheral triangular fibrocartilage complex (TFCC) tear is a promising, minimally invasive surgical technique, especially in patients with symptomatic distal radioulnar joint (DRUJ) instability. The purpose of this study was to evaluate the clinical result of arthroscopic one-tunnel transosseous foveal repair for peripheral TFCC tears. METHODS: Sixteen patients who underwent TFCC foveal repair were retrospectively evaluated. The mean follow-up period was 31...
November 9, 2017: Archives of Orthopaedic and Trauma Surgery
Yonglin Gao, Yunzhi Wang, Kezhou Wang, Jing Zhu, Guisheng Li, Jingwei Tian, Chunmei Li, Zhenhua Wang, Ji Li, Albert W Lee, Chenghua Guo
Clinopodium chinense (Benth.) O. Ktze (Labiatae), known as 'Duanxueliu' in the Chinese Pharmacopoeia, has been widely used as a traditional Chinese medicine for the treatment of hemorrhagic disease. Total flavonoids from Clinopodium chinense (Benth.) O. Ktze (TFCC), the most active ingredient, possess a variety of properties, such as antioxygenation. Until now, evidence-based toxicity data on TFCC has been limited. This study evaluated the acute (in mice and rat) and the 28-day repeated-dose (in rat) toxicity study of TFCC, respectively...
October 30, 2017: Regulatory Toxicology and Pharmacology: RTP
Jean Jose, Azael Arizpe, Carlos M Barrera, Nisreen Shabbir Ezuddin, David Chen
The triangular fibrocartilage complex (TFCC) is an intricate ligamentous and cartilaginous structure that helps transmit axial load across the wrist, and provide stability to the ulnocarpal and distal radioulnar joints (DRUJ). Because the blood supply to the TFCC varies depending on location, certain types of tears are more amenable to surgical repair than others. Since Palmer proposed his classification system of TFCC tears in 1989, only 1 case of a "bucket-handle" type tear has been reported. In this article, we describe two new cases of bucket-handle tears of the TFCC...
October 27, 2017: Skeletal Radiology
Katerina Kasapinova, Viktor Kamiloski
STUDY DESIGN: Prospective cohort. INTRODUCTION: Clinical studies that evaluate the correlation between associated lesions of the triangular fibrocartilage complex (TFCC) and outcome of distal radial fractures expressed with the patient-rated disability are missing. PURPOSE OF THE STUDY: To evaluate the outcomes of distal radius fractures associated with or without an injury of the TFCC. METHODS: Patients undergoing operative treatment for distal radial fracture were prospectively enrolled (n = 70)...
October 17, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Michael Chu-Kay Mak, Pak-Cheong Ho
Injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. Volar and dorsal radioulnar ligaments and their foveal insertion are the most important stabilizing components of the TFCC. In irreparable tears, anatomic reconstruction of the TFCC aims to restore normal biomechanics and stability of the distal radioulnar joint. We proposed a novel arthroscopic-assisted technique using a palmaris longus tendon graft. Arthroscopic-assisted TFCC reconstruction is a safe and effective approach with outcomes comparable to conventional open reconstruction and may result in a better range of motion from minimizing soft tissue dissection and subsequent scarring...
November 2017: Hand Clinics
Keiji Fujio
The deep component of triangular fibrocartilage complex (TFCC) inserts onto the fovea of the ulnar head. This component is critical to provide distal radioulnar joint stability. The surgical techniques and results of transosseous inside-out TFCC foveal repair are discussed. The rewarding results encouraged the repair of TFCC to the fovea arthroscopically. Although the results are good, the factors of age (traumatic or degenerative) and quality of stump and TFCC proper, which relate to the results should be considered in the future...
November 2017: Hand Clinics
Jan Ragnar Haugstvedt, Endre Søreide
Patients suffering from ulnar-sided wrist pain after trauma may develop tenderness, clicking, a positive fovea sign, or instability of the distal radioulnar joint. If the pain is persistent, conservative treatment does not help, and the patient agrees to surgery, arthroscopy may reveal a triangular fibrocartilage complex (TFCC) injury with capsular detachment, foveal avulsion, or a combination thereof. Capsular reattachment is possible using an arthroscopic assisted technique. The reattachment can be performed with an inside-out, outside-in, or all-inside technique, providing good to excellent results, which tend to persist over time, in 60% to 90% of cases...
November 2017: Hand Clinics
Taichi Saito, Jennifer M Sterbenz, Kevin C Chung
This article shows trends in triangular fibrocartilage complex (TFCC) repair since 1990 by geographic area and year. The repair methods presented in the literature were inside-out, outside-in, all-inside, and open repair. The outside-in technique was reported most often for ulnar-side tears, whereas the inside-out technique was reported most frequently for radial-side tears. Recently, a foveal reattachment technique for ulnar-side tears has garnered attention and has been reported with increasing frequency, especially in Asia, because the deepest portion of TFCC, attached to fovea, plays a key role in stabilizing the distal radioulnar joint...
November 2017: Hand Clinics
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