The medium term outcomes of an all-arthroscopic triangular fibrocartilage complex foveal reconstruction using tendon graft

Abstract

In patients with symptomatic chronic tear of the triangular fibrocartilage complex (TFCC), reconstruction with a tendon graft is indicated. We propose an arthroscopic-assisted technique to reconstruct the TFCC and to stabilize the distal radioulnar joint. Patients with a chronic foveal TFCC tear of which it is deem not reparable were recruited. TFCC reconstruction was performed by making use of the TFCC remnants and a palmaris tendon graft under arthroscopic guidance. Twelve patients with an average age of 29 years old were evaluated. Three patients had concomitant ulnar shortening procedure. The average follow-up period was 29 months. All patients had stable DRUJ. Significant improvement was noted for pain score (from 4 to 1), DASH score (from 31 to 9.5), and Mayo modified wrist score (from 82 to 95). Grip strength was improved and the range of movement of the wrist was maintained. No complication nor graft re-rupture was noted. This is a viable arthroscopic technique of TFCC reconstruction in a selected group of patients who had chronic foveal TFCC tear.