title: Reconstruction of Chronic Foveal TFCC Tears with an Autologous Tendon Graft.
abstract: Background A triangular fibrocartilage complex (TFCC) injury can produce distal radioulnar joint (DRUJ) instability. If the foveal attachment is avulsed, it translates distally. The footprint is separated from its origin and will become covered in synovitis, preventing healing. The authors describe a surgical technique for the treatment of instability of the DRUJ due to chronic foveal detachment of the TFCC. Technique The procedure utilizes a loop of autologous palmaris longus tendon graft passed through the ulnar aspect of the TFCC and through an osseous tunnel in the distal ulna to reconstruct the fovel attachment. Patients and Methods We report on nine patients with a mean age of 42. Median follow-up was 13 months. Results The median pain scores measured were reduced from 8 to 3 postoperatively, and all had a stable DRUJ. Conclusions This technique provides stability of the distal ulna to the radius and carpus, with potential for biologic healing through osseous integration. It is a robust, anatomically based reconstruction of the TFCC to the fovea that stabilizes the DRUJ and the ulnar-carpal sag.
authors.affiliation: Department of Orthopaedic Surgery, Flinders University of South Australia, South Australia, Australia.
authors.forename: Gregory I
authors.initials: GI
authors.lastname: Bain
authors.affiliation: Barwon Orthopaedic Research Unit, Geelong University Hospital. Geelong, Victoria, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Eng
authors.affiliation: Department of Orthopaedic Surgery, Modbury Public Hospital, Adelaide, Australia.
authors.forename: Yu Chao
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa.
authors.forename: Duncan
authors.initials: D
authors.lastname: Mcguire
authors.affiliation: Upper Extremity Unit, Department of Orthopaedic Surgery Traumatology, University of Bern, Inselspital, Bern, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Zumstein
keywords: DRUJ instability; foveal tear; triangular fibrocartilage complex