Our Summary

This research paper discusses the injuries associated with the triangular fibrocartilaginous complex (TFCC), a part of the wrist that is often damaged in cases of trauma. The TFCC lesions are classified based on their location and whether they are caused by injury or degeneration. The article explores different methods for treating TFCC injuries, including conservative, operative, and arthroscopic surgical techniques. The main goal of any treatment should be to stabilize the joint by reattaching the torn ligaments. This can be achieved through several techniques such as a transosseous suture, a suture anchor or an open procedure. Central TFCC tears, which are usually located close to the sigmoid notch of the radius, can be treated by arthroscopic debridement using small joint punches or a bipolar high frequency system. The ulnar TFCC avulsions can also be refixed arthroscopically using different techniques.

FAQs

  1. What is the Triangular Fibrocartilaginous Complex (TFCC) and how can it be damaged?
  2. What are the different methods for treating TFCC injuries as mentioned in the article?
  3. How can central TFCC tears and ulnar TFCC avulsions be treated arthroscopically?

Doctor’s Tip

A doctor might tell a patient undergoing wrist arthroscopy to follow post-operative care instructions carefully, including keeping the wrist elevated and applying ice to reduce swelling. It is important to attend follow-up appointments and physical therapy sessions to aid in the recovery process and regain strength and mobility in the wrist. It is also important to avoid activities that may put strain on the wrist during the healing process to prevent further injury.

Suitable For

Patients who are typically recommended wrist arthroscopy are those who have sustained injuries to the TFCC, such as:

  • Traumatic tears of the TFCC
  • Degenerative tears of the TFCC
  • Ulnar-sided wrist pain
  • Chronic wrist instability
  • Ganglion cysts
  • Fractures of the wrist

Patients who have not responded to conservative treatments such as rest, immobilization, physical therapy, and corticosteroid injections may be candidates for wrist arthroscopy. Additionally, patients who have persistent pain, swelling, clicking or locking of the wrist joint may also benefit from this minimally invasive surgical procedure. It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if wrist arthroscopy is the most appropriate treatment option for their specific condition.

Timeline

Before wrist arthroscopy:

  1. Patient experiences wrist pain, swelling, and limited range of motion.
  2. Patient undergoes physical examination, imaging tests such as X-rays and MRI, and possibly a wrist arthroscopy consultation.
  3. Treatment options such as rest, medication, physical therapy, or corticosteroid injections may be recommended.

After wrist arthroscopy:

  1. Patient undergoes wrist arthroscopy procedure to repair TFCC injury.
  2. Patient may experience mild pain and swelling post-surgery, which can be managed with pain medication and ice.
  3. Patient undergoes physical therapy to regain strength and range of motion in the wrist.
  4. Patient follows a rehabilitation program to gradually return to normal activities and sports.
  5. Patient attends follow-up appointments with the surgeon to monitor healing and progress.

What to Ask Your Doctor

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

  • What is the specific reason for recommending wrist arthroscopy in my case?
  • What are the potential risks and complications associated with wrist arthroscopy?
  • What are the expected outcomes and recovery time following wrist arthroscopy?
  • Are there any alternative treatment options to consider before proceeding with wrist arthroscopy?
  • How experienced are you in performing wrist arthroscopy procedures?
  • Will I need physical therapy or rehabilitation after the procedure?
  • What will the post-operative care involve, and what restrictions or limitations will I have during the recovery period?
  • How long will it take for me to resume normal activities and return to work following wrist arthroscopy?
  • What should I do if I experience any unexpected symptoms or complications after the procedure?
  • Are there any long-term implications or considerations to be aware of after undergoing wrist arthroscopy?

Reference

Authors: Mannil L, Martin W, Dahmen J, Witte T, Juten PG, Deneken F, Räder M, Homann HH. Journal: Eur J Trauma Emerg Surg. 2016 Feb;42(1):29-35. doi: 10.1007/s00068-015-0593-x. Epub 2015 Nov 13. PMID: 26566794