title: All-arthroscopic repair of Palmer 1B triangular fibrocartilage complex tears using the FasT-Fix device.
abstract: OBJECTIVE
  The FasT-Fix device (Smith and Nephew Endoscopy, Andover, MA), initially developed for knee meniscal tears, is described for all-arthroscopic triangular fibrocartilage complex (TFCC) repairs. Potential benefits of this technique are ease of use, the lack of prominent suture knots, and strength of repair. This case series evaluates the early clinical outcomes of this technique.
  
  
  METHODS
  We conducted a retrospective review of patients with TFCC Palmer type 1B injuries treated by 1 hand surgeon from 2005 to 2009. The patients' charts were reviewed for postoperative complications, range of motion, grip strength (percentage of contralateral), and return to full activity. In addition, each patient completed Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and Patient-Rated Wrist Evaluation (PRWE) questionnaires.
  
  
  RESULTS
  Twelve patients had all-arthroscopic peripheral (1B) TFCC repairs using the FasT-Fix suture device. The mean follow-up period was 17.5 months (range, 11-27). Mean supination was 78° (± 14°), and mean grip strength was 64% (±16%) of the nonsurgical extremity by 3 months after surgery. All other range of motion was full. The mean QuickDASH score was 11 (±12), and the mean PRWE score was 19 (±14). Average time to full activity was 5 months. There were no surgical complications of the procedure. One patient complained of persistent ulnar-sided wrist pain 12 months after surgery and had an ulnar shortening osteotomy. Arthroscopy at the time of the osteotomy revealed that the TFCC was stable.
  
  
  CONCLUSIONS
  At mean 1-year follow-up, 11 out of 12 patients achieved excellent subjective outcomes based on QuickDASH and PRWE questionnaires. Although range of motion and grip strength were slightly decreased compared to prior case series reports, the short-term results indicate that the FasT-Fix all-arthroscopic, all-inside technique is a safe and effective technique for repair of Palmer type 1B TFCC tears.
authors: Department of Orthopaedic Surgery, Stanford University Medical Center, City, Stanford, CA 94063, USA. jyao@stanford.edu
authors: Jeffrey
authors: J
authors: Yao
authors: Arthur T
authors: AT
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome; D051478:Triangular Fibrocartilage / Q000293:injuries / Q000601:surgery*; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult