title: Biomechanical comparison of transosseous and capsular repair of peripheral triangular fibrocartilage tears.
abstract: OBJECTIVE
  The purpose of this study was to biomechanically compare the repair strength of peripheral triangular fibrocartilage complex (TFCC) repairs to the distal ulna using transosseous sutures (group I) versus TFCC repairs to the extensor carpi ulnaris tendon subsheath and surrounding dorsal capsule (group II).
  
  
  METHODS
  Cadaveric biomechanical study.
  
  
  METHODS
  Six matched pairs of fresh-frozen cadaveric upper extremities were procured. Each underwent the creation and repair of a peripheral, ulnar-sided detachment of the TFCC. Following stabilization of the humerus and radius, the maximum translations of the ulna in the dorsal and palmar directions were measured in response to an 8-lb traction load before disrupting the TFCC, after disrupting the TFCC, and after repairing the TFCC.
  
  
  RESULTS
  There was a significant increase in the total translation of the ulna following disruption of the TFCC (P <.001) in both groups. The mean and standard deviation of the percent total translation eliminated following TFCC repair for group I specimens (transosseous suture) were 33.8% and 11.6%, respectively. The mean and standard deviation of the percent total translation eliminated following TFCC repair for group II specimens (capsular implantation) were 59.3% and 29.7%, respectively. The observed difference between the repair groups is not significant (P =.157).
  
  
  CONCLUSIONS
  While disruption of the TFCC does significantly increase distal radioulnar joint (DRUJ) instability and repair of the TFCC does significantly restore DRUJ stability, the results of this study do not show a significant biomechanical difference between the 2 TFCC repair techniques in a cadaveric model.
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. druch@wfubmc.edu
authors.forename: David S
authors.initials: DS
authors.lastname: Ruch
authors.forename: Steven R
authors.initials: SR
authors.lastname: Anderson
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Ritter
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D002358:Cartilage, Articular / Q000601:surgery*; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000601:surgery*; D007593:Joint Instability / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques; D014457:Ulna / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*