title: Arthroscopically assisted reconstruction of triangular fibrocartilage complex foveal avulsion in the ulnar variance-positive patient.
abstract: OBJECTIVE
  Our aim was to evaluate the clinical results of patients treated by arthroscopically assisted reconstruction of foveal avulsion injury of the triangular fibrocartilage complex (TFCC) using a suture anchor.
  
  
  METHODS
  We retrospectively reviewed the results of 15 patients (11 men and 4 women; mean age, 30.5 years) who underwent surgical procedures for the treatment of TFCC foveal avulsion at our hospital. The patients were followed up for a mean of 29 months. The patients had TFCC foveal avulsion caused by sprains (n = 8), falls (n = 4), playing baseball (n = 2), and a motor vehicle accident (n = 1). All the patients underwent magnetic resonance imaging. Radiographs obtained to assess ulnar variance (UV), ulnar-dorsal subluxation, and function of the wrist based on grip power; Disabilities of the Arm, Shoulder and Hand score; and Mayo wrist score were examined for all patients both preoperatively and postoperatively.
  
  
  RESULTS
  On preoperative magnetic resonance imaging, TFCC foveal avulsion was observed in 13 of 15 cases. The mean UV value based on preoperative simple radiographic findings was 1.7 ± 1.0 mm, and dorsal subluxation at the distal ulna improved from 2.9 ± 3.0 mm to 0.2 ± 0.9 mm (P = .017). In all cases the distal radioulnar joint instability disappeared postoperatively. Grip power (compared with the uninvolved limb) was 79.3% preoperatively and 82.9% postoperatively (P = .086). The Disabilities of the Arm, Shoulder and Hand scores were 28.4 points preoperatively and 16.6 points postoperatively (P = .061). The Mayo wrist scores were excellent in 10 cases, good in 2, and fair in 3, and the mean score improved significantly from 64 points preoperatively to 84 points postoperatively (P = .007).
  
  
  CONCLUSIONS
  Arthroscopic-assisted suture anchor reattachment of the TFCC in patients with traumatic TFCC foveal avulsion can prevent or reduce distal radioulnar joint instability and reduce pain even in chronic cases with positive UV.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopedic Surgery, Soonchunhyang University, Bucheon Hospital, Bucheon, South Korea.
authors.forename: ByungSung
authors.initials: B
authors.lastname: Kim
authors.forename: Hong-Kee
authors.initials: HK
authors.lastname: Yoon
authors.forename: Jae-Hwi
authors.initials: JH
authors.lastname: Nho
authors.forename: Kang Hee
authors.initials: KH
authors.lastname: Park
authors.forename: Sung-Yong
authors.initials: SY
authors.lastname: Park
authors.forename: Jun-Hee
authors.initials: JH
authors.lastname: Yoon
authors.forename: Hyun Seok
authors.initials: HS
authors.lastname: Song
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D053441:Suture Anchors; D016896:Treatment Outcome; D051478:Triangular Fibrocartilage / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D014457:Ulna / Q000000981:diagnostic imaging / Q000473:pathology; D014954:Wrist Injuries / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult