title: Comparison between open and arthroscopic-assisted foveal triangular fibrocartilage complex repair for post-traumatic distal radio-ulnar joint instability.
abstract: The aim of this study was to assess the objective and subjective functional outcomes after foveal reattachment of proximal or complete ulnar-sided triangular fibrocartilage complex lesions by two surgical procedures: an open technique or an arthroscopically assisted repair. The study was done prospectively on 49 wrists affected by post-traumatic distal radio-ulnar joint instability. Twenty-four patients were treated with the open technique (Group 1) and 25 by the arthroscopically assisted technique (Group 2). Magnetic resonance imaging demonstrated a clear foveal detachment of the triangular fibrocartilage complex in 67% of the cases. Arthroscopy showed a positive ulnar-sided detachment of the triangular fibrocartilage complex (positive hook test) in all cases. Distal radio-ulnar joint stability was obtained in all but five patients at a mean follow-up of 6 months. Both groups had improvement of all parameters with significant differences in wrist pain scores, Mayo wrist score, Disability of the Arm, Shoulder and Hand questionnaire and Patient-Rated Wrist/Hand Evaluation questionnaire scores. There were no significant post-operative differences between the two groups in the outcome parameters except for the Disability of the Arm Shoulder and Hand questionnaire score, which was significantly better in Group 2 (p < 0.001).
authors: Rimini Hand and Rehabilitation Center, Rimini, Italy rluc@adhoc.net.
authors: R
authors: R
authors: Luchetti
authors: Fenice Hand Surgery and Rehabilitation Team, Treviso, Pordenone, Italy.
authors: A
authors: A
authors: Atzei
authors: Rimini Hand and Rehabilitation Center, Rimini, Italy.
authors: R
authors: R
authors: Cozzolino
authors: Studio Fairplay, Hand Rehabilitation Private Center, Bologna, Italy.
authors: T
authors: T
authors: Fairplay
authors: Department of Hand Surgery and Surgery of Peripheral Nerves, University Hospital Bern, Bern, Switzerland.
authors: N
authors: N
authors: Badur
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051478:Triangular Fibrocartilage / Q000293:injuries / Q000601:surgery*; D064232:Visual Analog Scale; D014954:Wrist Injuries / Q000150:complications / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*; D055815:Young Adult
keywords: Flexor carpi radialis tendonitis; basal joint arthritis; pseudotendon; suspensionplasty; tendon rupture; tenotomy