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https://www.readbyqxmd.com/read/28373941/arthroscopically-assisted-transosseous-foveal-repair-of-triangular-fibrocartilage-complex
#1
Wei-Jen Chen
The radioulnar ligament of the triangular fibrocartilage complex (TFCC), especially the deep fibers inserted at the ulnar fovea, is the key component for the distal radioulnar joint (DRUJ) stability. Traumatic injuries to the TFCC foveal insertion would cause DRUJ instability. Traditionally, arthroscopic techniques of the TFCC repair are suturing the ulnar-sided disruption peripherally to the dorsal or ulnar capsule instead of suturing the TFCC to the fovea and thus fail to restore the DRUJ stability if the TFCC is detached from the fovea...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28345546/high-resolution-3t-magnetic-resonance-imaging-of-the-triangular-fibrocartilage-complex-in-chinese-wrists-correlation-with-cross-sectional-anatomy
#2
Hui-Li Zhan, Wen-Ting Li, Rong-Jie Bai, Nai-Li Wang, Zhan-Hua Qian, Wei Ye, Yu-Ming Yin
BACKGROUND: The injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) could demonstrate the detailed complex anatomy of TFCC in Chinese. METHODS: Fourteen Chinese cadaveric wrists (from four men and three women; age range at death from 30 to 60 years; mean age at 46 years) and forty healthy Chinese wrists (from 20 healthy volunteers, male/female: 10/10; age range from 21 to 53 years with a mean age of 32 years) in Beijing Jishuitan Hospital from March 2014 to March 2016 were included in this study...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28339356/diagnostic-accuracy-of-musculoskeletal-ultrasound-and-conventional-radiography-in-the-assessment-of-the-wrist-triangular-fibrocartilage-complex-in-patients-with-definite-diagnosis-of-calcium-pyrophosphate-dihydrate-deposition-disease
#3
Andrea Di Matteo, Emilio Filippucci, Fausto Salaffi, Marina Carotti, Davide Carboni, Eleonora Di Donato, Walter Grassi
OBJECTIVES: To compare the diagnostic accuracy of musculoskeletal ultrasound (MSUS) and x-ray in evaluating wrist triangular fibrocartilage complex (TFCC) in patients with calcium pyrophosphate dihydrate deposition disease (CPPD) and to investigate the agreement between the extent of the calcium pyrophosphate dihydrate (CPP) crystal deposits assessed by MSUS and the radiographic findings. METHODS: We enrolled 84 patients: 36 patients with "definite" CPPD and 48 controls...
March 23, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28259283/impact-of-distal-ulnar-fracture-malunion-on-distal-radioulnar-joint-instability-a-biomechanical-study-of-the-distal-interosseous-membrane-using-a-cadaver-model
#4
Satoshi Miyamura, Atsuo Shigi, Jirachart Kraisarin, Shohei Omokawa, Tsuyoshi Murase, Hideki Yoshikawa, Hisao Moritomo
PURPOSE: Certain distal ulna fractures may contribute to distal radioulnar joint (DRUJ) instability. We hypothesized that residual distal ulna translation could affect DRUJ stability by slackening the distal interosseous membrane (DIOM). We aimed to test this hypothesis in a cadaver model. METHODS: We created an ulnar translated distal ulna fracture model in 6 cadavers. Dorsal and palmar displacements of the ulna relative to the radius were measured and DRUJ instability was staged under the following conditions: (1) 0-, 2-, and 4-mm ulnar translation of the distal ulna with an intact triangular fibrocartilage complex (TFCC) and DIOM; (2) 0-, 2-, and 4-mm translations with TFCC divided and an intact DIOM; and (3) a 0-mm translation with TFCC and DIOM divided...
March 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28246600/can-the-diagnostics-of-triangular-fibrocartilage-complex-lesions-be-improved-by-mri-based-soft-tissue-reconstruction-an-imaging-based-workup-and-case-presentation
#5
Niels Hammer, Ulrich Hirschfeld, Hendrik Strunz, Michael Werner, Thomas Wolfskämpf, Sabine Löffler
Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT), 3 T magnetic resonance imaging (MRI), and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28211292/clinical-and-functional-outcome-of-open-primary-repair-of-triangular-fibrocartilage-complex-tears-associated-with-distal-radius-fractures
#6
Faisal Johandi, Sreedharan Sechachalam
PURPOSE: We evaluate the clinical and functional outcome of open primary repair of acute TFCC tears in distal radius fracture, when there is gross intraoperative distal radioulnar joint (DRUJ) instability after fixation of the distal radius, in the absence of an ulnar styloid fracture or when the ulnar fracture fragment is too small to be fixed. METHODS: A retrospective review of our institution's distal radius fracture database over a 4-year period (January 2010 to December 2013)...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28185125/ulnar-sided-wrist-pain-in-the-athlete-tfcc-druj-ecu
#7
REVIEW
Eric Quan Pang, Jeffrey Yao
PURPOSE OF REVIEW: The goal of this manuscript is to review key historic and recent literature regarding extensor carpi ulnaris (ECU), triangular fibrocartilage complex (TFCC) and distal radioulnar joint (DRUJ) injuries, particularly in athletes. RECENT FINDINGS: Many recent studies examining the ECU focus on clinical and radiographic diagnosis. Several physical exam findings are described in addition to the use of MRI and US. Imaging studies must be clinically correlated due to high incidence of findings in asymptomatic patients...
March 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28119800/ulna-rotation-osteotomy-in-complete-dislocation-of-the-distal-radioulnar-joint
#8
Markus Gabl, Rohit Arora, Eva Maria Gassner, Gernot Schmidle
Background Complete dislocation of the distal radioulnar joint (DRUJ) is a rare injury. Dislocation can present as uni- or multidirectional, acute or chronic, reducible or irreducible. It can occur due to isolated loss of ligamentous restraints or more frequent in Galeazzi - or Essex-Lopresti-type fractures. Case Description A 28-year-old man sustained a distal radius fracture and presented after conservative treatment with blocked supination. Examination revealed a malunion of the distal radius in combination with an irreducible dorsal dislocation of the DRUJ...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28119793/preventable-repeat-wrist-arthroscopies-analysis-of-the-indications-for-133-cases
#9
Steffen Löw, Christian K Spies, Frank Unglaub, Jörg van Schoonhoven, Karl-Josef Prommersberger, Marion Mühldorfer-Fodor
Background Frequently, patients undergo repeated wrist arthroscopies for single wrist problems. Purpose The purposes of this study were to assess the indications for repeat wrist arthroscopies and to identify potentially preventable procedures. Methods For this retrospective, two-center study, the electronic patient records were examined for patients, who underwent repeat wrist arthroscopy in a 5-year period. The cases were sorted by the underlying pathologies and the causes that necessitated repeat arthroscopies...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28034486/biomechanical-comparison-of-open-and-arthroscopic-transosseous-repair-of-triangular-fibrocartilage-complex-foveal-tears-a-cadaveric-study
#10
Ching-Hou Ma, Ting-Sheng Lin, Chin-Hsien Wu, Dong-Yi Li, Shih-Chieh Yang, Yuan-Kun Tu
PURPOSE: To biomechanically compare the stability between open repair and arthroscopic transosseous repair technique for reattachment of the foveal triangular fibrocartilage complex (TFCC). We also evaluated the feasibility of a new aiming device for the creation of 2 bone tunnels simultaneously during the arthroscopic technique. METHODS: Six matched pairs of fresh-frozen forearm cadaver specimens were prepared for testing. Group I specimens were treated by open repair with suture anchor...
February 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27917687/a-long-term-20-years-follow-up-after-arthroscopically-assisted-repair-of-the-tfcc
#11
Endre Soreide, Torstein Husby, Jan Ragnar Haugstvedt
OBJECTIVE: The present study aimed to assess long-term functional outcome for patients after arthroscopic assisted suture for peripheral tears of the triangular fibrocartilage complex (TFCC). METHODS: Eleven patients, 26 (15-59) years old at time of surgery, 48 (35-78) years old at time of follow-up, were available for this 20-year follow-up. Subjective and objective outcomes, such as range of motion, grip strength, patients' satisfaction, pain, and Mayo Modified Wrist Score, were assessed, as well as asking the question if the patients would have had the surgery done again, knowing the outcome, based on a clinical examination and patient reported questionnaires...
December 5, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27909756/-ligament-injuries-of-the-wrist
#12
R Schmitt
The distal radioulnar joint, the triangular fibrocartilage complex (TFCC) and the wrist are stabilized by many ligaments allowing not only a wide range of motion but also providing sufficient stability. The complex arrangement of carpal ligaments and prosupination around the forearm joint enables multiaxial motion patterns. In the wrist, intra-articular ligaments can be differentiated from extra-articular capsular ligaments as well as intrinsic and extrinsic ligament courses. Imaging is essential for classification of dynamic and static instability patterns...
December 2016: Der Radiologe
https://www.readbyqxmd.com/read/27890214/-pathology-of-the-triangular-fibrocartilaginous-complex-in-distal-radius-fractures
#13
D Fontès
Distal radius fracture is actually quite rarely isolated and triangular fibrocartilaginous complex (TFCC) is often involved with the same mechanism of injury. A contemporary management of the treatment of the initial fracture is ideal and so benefits from a routine arthroscopic management. Nevertheless, in the absence of diagnosis and therefore early treatment, the symptoms may be located at the ulnar crossroads and justify specific treatment of TFCC. It is generally conducted after an accurate arthroscopic lesion classification guiding a procedure, depending on the lesion vascularization as well as its possible destabilization potential (debridement, capsular suture or foveal reattachment)...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27857481/short-term-evaluation-of-arthroscopic-outside-in-repair-of-ulnar-side-tfcc-tear-with-vertical-mattress-suture
#14
Maysara Abdelhalim Bayoumy, Hesham A Elkady, Hatem G Said, Amr El-Sayed, Waleed Riad Saleh
BACKGROUND: There has been controversy regarding the pathogenesis and treatment of TFCC tear. Different surgical techniques for the treatment of TFCC are prescribed. The purpose of this study was to evaluate the short-term outcomes of arthroscopic outside-in repair of the ulnar side TFCC tear with vertical mattress suture. METHODS: In this study, arthroscopic outside-in repair of the ulnar side TFCC tear was done. 37 patients with TFCC tear with failure of conservative treatment for a minimum of 6 months had surgery...
December 2016: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27614390/proximity-of-the-triangular-fibrocartilage-complex-to-key-surrounding-structures-and-safety-assessment-of-an-arthroscopic-repair-technique-a-cadaveric-study
#15
Marshall A Kuremsky, Nahir Habet, Richard D Peindl, R Glenn Gaston
PURPOSE: To quantify the distance of the dorsal ulnar sensory branch, floor of the extensor carpi ulnaris (ECU) subsheath, and ulnar neurovascular bundles from the triangular fibrocartilage complex (TFCC), and secondarily to assess the safety of an all-inside arthroscopic repair of the TFCC with a commonly used meniscal repair device with respect to the aforementioned structures. METHODS: A custom K-wire with 1-mm gradation was used to determine the distance of at-risk structures from the periphery of the TFCC in 13 above-elbow human cadaver specimens...
December 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27595945/arthroscopic-trans-osseous-suture-of-peripheral-triangular-fibrocartilage-complex-tear
#16
Midum Jegal, Kang Heo, Jong Pil Kim
The importance of foveal repair of the triangular fibrocartilage complex (TFCC) on stability of the distal radioulnar joint (DRUJ) has been emphasized with increasing knowledge of the anatomy and biomechanics of the TFCC and DRUJ. Although both open and arthroscopic techniques have been described for improving DRUJ stability, there has been a marked evolution of arthroscopic TFCC repair technique with successful clinical outcome. Recently, an arthroscopic trans-osseous technique has been described to repair foveal tears of the TFCC...
October 2016: J Hand Surg Asian Pac Vol
https://www.readbyqxmd.com/read/27535592/high-resolution-3t-mr-imaging-of-the-triangular-fibrocartilage-complex
#17
Donald von Borstel, Michael Wang, Kirstin Small, Taiki Nozaki, Hiroshi Yoshioka
This study is intended as a review of 3Tesla (T) magnetic resonance (MR) imaging of the triangular fibrocartilage complex (TFCC). The recent advances in MR imaging, which includes high field strength magnets, multi-channel coils, and isotropic 3-dimensional (3D) sequences have enabled the visualization of precise TFCC anatomy with high spatial and contrast resolution. In addition to the routine wrist protocol, there are specific techniques used to optimize 3T imaging of the wrist; including driven equilibrium sequence (DRIVE), parallel imaging, and 3D imaging...
January 10, 2017: Magnetic Resonance in Medical Sciences: MRMS
https://www.readbyqxmd.com/read/27499320/effect-of-ulnar-styloid-fracture-on-outcomes-after-conservative-treatment-of-distal-radius-fracture
#18
Sualp Turan, Deniz Çankaya, Serdar Yılmaz, Dilek Karakuş, Abdurrahim Dündar, Güzelali Özdemir
OBJECTIVES: This study aims to investigate the effect of accompanying ulnar styloid fracture (USF) on clinical outcomes and hand-wrist muscle strength in conservatively treated active patients after displaced distal radius fracture (DRF). PATIENTS AND METHODS: The retrospective study, which was conducted November 2012 and September 2016, included 56 patients (34 males, 22 females; mean age 28.8 years; range 20 to 40 years) with displaced DRF treated with closed reduction and casting...
August 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27491857/-arthroscopically-assisted-transcapsular-refixation-of-the-triangular-fibrocartilage-complex-of-the-wrist
#19
T Pillukat, R A Fuhrmann, J Windolf, J van Schoonhoven
OBJECTIVE: Refixation of the triangular fibrocartilage complex (TFCC) to the ulnar capsule of the wrist. INDICATIONS: Distal TFCC tears without instability, proximal TFCC intact. Loose ulnar TFCC attachment without tear or instability. CONTRAINDICATIONS: Peripheral TFCC tears with instability of the distal radioulnar joint (DRUJ). Complex or proximal tears of the TFCC. Isolated, central degenerative tears without healing potential. SURGICAL TECHNIQUE: Arthroscopically guided, minimally invasive suture of the TFCC to the base of the sixth extensor compartment...
August 2016: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/27379858/-arthroscopic-partial-resection-of-the-ulnar-head-for-ulnocarpal-decompression
#20
T Del Gaudio, M Haerle
OBJECTIVE: Arthroscopic decompression (wafer procedure) of the ulnocarpal compartment in patients with ulnar impaction syndrome. INDICATIONS: The arthroscopic wafer procedure is recommended in ulnar-plus situations with up to 3 mm length-excess. To perform this procedure the ulnar head needs to be accessible for the burr through a pre-existing, impaction-related, centroradial lesion of the triangular fibrocartilage complex (TFCC). The additional presence of a distal radioulnar joint (DRUJ) type C confirms the indication...
August 2016: Operative Orthopädie und Traumatologie
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