Our Summary

The triangular fibrocartilage complex (TFCC) is a crucial part of our wrist that keeps it stable. When it gets injured, it can cause a lot of pain in the ulnar wrist, which is the side of your wrist near your pinky finger. If the injury doesn’t get better with basic treatment, then surgery might be needed. One particular type of TFCC injury, called Palmer type IB, is close to the blood supply area, so it’s considered a peripheral injury. Arthroscopic suture repair is a surgical method that’s become the go-to for fixing this type of injury, because it promotes a lot of healing. This study looks into the structure of the TFCC, how injuries to it are classified, and how arthroscopic suturing has improved the treatment of Palmer type IB injuries.

FAQs

  1. What is the triangular fibrocartilage complex (TFCC) and why is it important for wrist stability?
  2. What is the preferred surgical method for TFCC injury repair and why?
  3. How does a Palmer type IB tear differ from other types of TFCC injuries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about wrist arthroscopy is to follow post-operative instructions carefully, including keeping the wrist elevated, applying ice as needed, and doing prescribed exercises to aid in recovery and prevent stiffness. It is also important to attend follow-up appointments to ensure proper healing and address any concerns promptly.

Suitable For

Patients who are experiencing ulnar wrist pain due to a TFCC injury that has not responded to conservative treatment are typically recommended for wrist arthroscopy. Specifically, patients with Palmer type IB tears, which are peripheral injuries with a strong potential for healing through arthroscopic suture repair, are good candidates for this surgical procedure.

Timeline

Before wrist arthroscopy:

  • Patient experiences persistent ulnar wrist pain that is not relieved by conservative treatment.
  • Patient undergoes diagnostic imaging such as MRI to confirm TFCC injury.
  • Surgeon determines that arthroscopic suture repair is necessary for Palmer type IB tears.
  • Patient undergoes pre-operative evaluation and preparation for surgery.

After wrist arthroscopy:

  • Patient undergoes arthroscopic suture repair for TFCC injury.
  • Patient is monitored closely post-operatively for any complications.
  • Patient undergoes physical therapy for wrist rehabilitation.
  • Patient gradually resumes normal activities with improved wrist stability and decreased pain.
  • Patient follows up with surgeon for post-operative evaluations and ongoing care.

What to Ask Your Doctor

  1. What is wrist arthroscopy and how can it help with my TFCC injury?

  2. What are the potential risks and complications associated with wrist arthroscopy?

  3. What is the success rate of arthroscopic suture repair for Palmer type IB TFCC injuries?

  4. How long is the recovery process after wrist arthroscopy for a TFCC injury?

  5. What alternative treatment options are available for TFCC injuries if arthroscopy is not recommended?

  6. How many arthroscopic TFCC repairs have you performed and what is your success rate?

  7. What type of anesthesia will be used during the procedure and how long will I be in the hospital?

  8. Will I need physical therapy after the arthroscopic TFCC repair surgery?

  9. What can I expect in terms of pain management after the procedure?

  10. Are there any restrictions or limitations I should be aware of during the recovery period following wrist arthroscopy for a TFCC injury?

Reference

Authors: Jin J, Liang K, Wang L, Ye P, Wang J, Shi H. Journal: Sports Med Arthrosc Rev. 2023 Jun 1;31(2):49-59. doi: 10.1097/JSA.0000000000000366. Epub 2023 Jul 5. PMID: 37418174