title: [Treatment of triangular fibrocartilage complex tear under wrist arthroscopy].
abstract: OBJECTIVE
  To evaluate the treatment and effects of wrist arthroscopy in tear of triangular fibrocartilage complex (TFCC).
  
  
  METHODS
  Between January 2006 and December 2008, 16 patients with tear of TFCC were treated. Of 16 patients, 11 were male and 5 were female with an average age of 32.5 years (range, 25-51 years). Injury was caused by sprain in 12 cases, and by falling in 4 cases. The locations were the left side in 10 cases and the right side in 6 cases. The mean injury duration was 3 months to 6 years and 2 months. The main clinical symptoms included wrist powerlessness and ulnar-sided wrist pain which was aggravated with clench fist and lifting heavy things. The results of the ulnar-sided wrist stress test were positive in 14 cases and negative in 2 cases. The preoperative values of wrist range of motion (ROM) were (45.58 +/- 5.18) degrees at volar flexion, (41.22 +/- 3.83) degrees at dorsal extension, (17.82 +/- 2.48) degrees at radial deviation, (21.35 +/- 4.61) degrees at ulnar deviation, (69.85 +/- 8.36) degrees at pronation, and (70.13 +/- 6.34) degrees at supination. According to Palmer standard, 10 cases of IA were treated with debridement; 3 cases of IB with suture and 1 of them failed and was partially excised; 2 cases of IC with debridement on triangular fibrocartilage disc, ulnolunate ligament, and ulnotriguetrum ligament; and 1 case of ID with trimming plastic operation.
  
  
  RESULTS
  All incisions healed by first intention, and no complications of joint infection or neurovascular injury was found. All patients were followed up 14-38 months (mean, 18.5 months). Fifteen patients were restored to normal life and work without ulnar-sided wrist pain. One patient had no pain, but he had wrist powerless. The values of ROM at last follow-up were (50.16 +/- 6.21) degrees at volar flexion, (45.37 +/- 4.65) degrees at dorsal extension, (18.95 +/- 3.56) degrees at radial deviation, (26.28 +/- 5.09) degrees at ulnar deviation, (78.87 +/- 7.69) degrees at pronation, and (76.46 +/- 8.31) degrees at supination; showing significant differences when compared with preoperative values (P < 0.05). According to Green-O'Brien standard, the results were excellent in 9 cases, good in 6 cases, fair in 1 case, and the excellent and good rate was 93.75%.
  
  
  CONCLUSIONS
  The wrist arthroscopy not only can definitely diagnose tear of TFCC, but also is useful for treatment. In addition, the incision is small and the function is easy to recover, and the occurrence of chronic ulnar-sided wrist pain can be effectively avoided.
authors.affiliation: Department of Orthopedic Trauma and Hand Surgery, No.1 Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning Guangxi, 530023, P.R. China. mk691900@yahoo.com.cn
authors.forename: Kun
authors.initials: K
authors.lastname: Mi
authors.forename: Wu
authors.initials: W
authors.lastname: Liu
authors.forename: Pengfei
authors.initials: P
authors.lastname: Liu
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Feng
authors.forename: Yuwen
authors.initials: Y
authors.lastname: Li
authors.forename: Guisheng
authors.initials: G
authors.lastname: Hui
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051478:Triangular Fibrocartilage / Q000293:injuries*; D014954:Wrist Injuries / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*