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Journal of Hand Surgery (European Volume)
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Articles

New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability

A. ATZEI

From the Hand Surgery Unit, Policlinico ‘G. B. Rossi’, Verona, Italy

Correspondence: Andrea Atzei, MD, Hand Surgery Unit, Policlinico ‘G. B. Rossi’, P. le L. A. Scuro, 10, 37100 Verona, Italy. Tel.: +39 3385036401; fax: +39 045914264. E-mail:andreatzei{at}libero.it;andreatzei{at}email.it.

Advances in radiocarpal and distal radioulnar joint (DRUJ) diagnostic arthroscopy permits a treatment-oriented classification of triangular fibrocartilage complex (TFCC) peripheral tears: 1) repairable distal tears; 2) repairable complete tears; 3) repairable proximal tears; 4) non-repairable tears; and 5) tears associated with DRUJ arthritis. Class 1 tears should be sutured; Class 2 and 3 are associated with DRUJ instability and require TFCC reattachment to the fovea; Class 4 tears need reconstruction using a tendon graft and Class 5 tears require an arthroplasty. Arthroscopic assisted TFCC foveal reattachment is possible through the direct foveal portal, a dedicated DRUJ working portal. Arthroscopic TFCC reconstruction using a tendon graft showed promising results.

Key Words: distal radioulnar joint • DRUJ • instability • triangular fibrocartilage complex • TFCC • wrist

This version was published on October 1, 2009

Journal of Hand Surgery (European Volume), Vol. 34, No. 5, 582-591 (2009)
DOI: 10.1177/1753193409100120
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