title: Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures.
abstract: The aim of this prospective study was to determine whether peripheral tears of the triangular fibrocartilage complex (TFCC) in patients younger than the osteoporotic age (males,<60 years; females, <50 years) were related to chronic distal radioulnar joint (DRUJ) instability. Fifty-one patients (27 women) with displaced distal radial fractures were included in the study. The median age was 41 years (range, 20-57 years). Arthroscopy at the time of fracture showed complete or partial TFCC tears in 43 patients (24 had only peripheral tears, 10 had only central perforations, and 9 had combined tears). The 1-year (range, 11-27 months) follow-up period included an interview, physical examination, and radiographic evaluation. Ten of the 11 patients with complete peripheral TFCC tears had DRUJ instability at the follow-up examination compared with 7 of the 32 patients with only partial or no peripheral tears. Patients with instability of the DRUJ had a worse Gartland and Werley wrist score. Instability was not associated with any radiographic finding either at the time of fracture or at the follow-up examination. Initial fracture or nonunion of the styloid was even slightly more common in stable patients.
authors.affiliation: Hand Unit, Department of Orthopedics, Lund University Hospital, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Lindau
authors.forename: C
authors.initials: C
authors.lastname: Adlercreutz
authors.forename: P
authors.initials: P
authors.lastname: Aspenberg
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007593:Joint Instability / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D011885:Radius Fractures / Q000150:complications* / Q000601:surgery*; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*