Our Summary

This research paper talks about a specific type of wrist injury - triangular fibrocartilage complex (TFCC) tears. These injuries, if not treated properly, can cause ongoing wrist pain. The paper reviews the latest research on this topic, including who is most likely to get this injury, what might cause it, and how to identify it through a physical examination and imaging like X-rays or MRI.

The paper also discusses when surgery might be necessary and what that surgery might look like. Two types of surgery are considered - open surgery, where a larger incision is made, or arthroscopic surgery, which uses smaller incisions and a tiny camera to guide the procedure. It also covers how the wrist is repaired during surgery, how it should be cared for after the operation, and what the expected outcomes are.

There’s still some debate about the best surgical technique, and this paper provides a comprehensive review of everything we currently know about this type of injury and how to treat it.

FAQs

  1. What is the current debate regarding the optimal surgical technique for TFCC tears?
  2. What are the risk factors for TFCC injury as described in the literature?
  3. What factors are considered in deciding between open and arthroscopic TFCC repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about wrist arthroscopy for TFCC tears is to follow the postoperative rehabilitation plan carefully to ensure proper healing and function of the wrist. This may include physical therapy exercises, wearing a splint or brace, and avoiding certain activities that could strain the wrist. It’s important to communicate any concerns or changes in symptoms to your doctor during the recovery process.

Suitable For

Patients who are typically recommended for wrist arthroscopy include those with persistent ulnar-sided wrist pain due to triangular fibrocartilage complex (TFCC) tears, whether acute or chronic. Other potential candidates for wrist arthroscopy may include those with ligament injuries, cartilage damage, joint inflammation, or loose bodies in the wrist joint. It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if wrist arthroscopy is the appropriate treatment option for their specific condition.

Timeline

Before wrist arthroscopy:

  • Patient experiences persistent ulnar-sided wrist pain
  • Diagnosis and nonsurgical management is attempted
  • Ongoing discussion about optimal surgical technique (open vs arthroscopic)
  • Demographics and risk factors for TFCC injury are considered
  • Classification of acute and chronic TFCC tears is determined
  • History and physical examination are conducted
  • Diagnostic imaging is used to confirm TFCC tear

After wrist arthroscopy:

  • Surgical indications for arthroscopy are determined
  • Surgical anatomy is considered during the procedure
  • Arthroscopic TFCC repair is performed
  • Fixation biomechanics and techniques are utilized
  • Postoperative rehabilitation is initiated
  • Clinical outcomes are monitored and evaluated for success and improvement.

What to Ask Your Doctor

Some questions a patient should ask their doctor about wrist arthroscopy for TFCC tears include:

  1. What is the specific diagnosis for my wrist pain and why is wrist arthroscopy recommended for my TFCC tear?
  2. What are the potential risks and complications associated with wrist arthroscopy for TFCC tears?
  3. What is the success rate of wrist arthroscopy for treating TFCC tears and what is the expected outcome?
  4. What is the recovery time and rehabilitation process like after wrist arthroscopy for TFCC tears?
  5. Are there any alternative treatment options for TFCC tears that I should consider before opting for wrist arthroscopy?
  6. How experienced are you in performing wrist arthroscopy for TFCC tears and what is your success rate with this procedure?
  7. Will I need any additional imaging or tests before the wrist arthroscopy procedure?
  8. What should I expect during the wrist arthroscopy procedure and how long will it take?
  9. Will I need to wear a cast or splint after the wrist arthroscopy procedure and for how long?
  10. How soon after the wrist arthroscopy procedure can I expect to return to normal activities and sports?

Reference

Authors: Srinivasan RC, Shrouder-Henry JJ, Richard MJ, Ruch DS. Journal: J Am Acad Orthop Surg. 2021 Jun 15;29(12):518-525. doi: 10.5435/JAAOS-D-20-00998. PMID: 34078841