title: Arthroscopic-Assisted Outside-In Repair of Triangular Fibrocartilage Complex Tears.
abstract: With advances in surgical instrumentation and techniques, as well as expanding surgical indications, wrist arthroscopy is now being used to treat a variety of conditions previously managed only with open techniques. Triangular fibrocartilage complex (TFCC) injuries remain among the most common causes of ulnar-sided wrist pain and can result from both acute and chronic mechanisms of injury. The most common mechanism of acute injury to the TFCC is a fall onto an outstretched hand with the wrist in a supinated, extended position. In patients with unrelenting pain, swelling, or mechanical symptoms despite a concerted effort at nonoperative management, which often consists of bracing, therapy, or injections, surgical intervention is often indicated. Treatment historically consisted of open exploration and repair; however, recently, arthroscopic-assisted and all-arthroscopic techniques have been described. We describe a safe, reproducible, and reliable surgical technique for arthroscopic-assisted outside-in repair of peripheral TFCC tears. In addition, a specific focus on surgical anatomy, including pearls and pitfalls for protecting the dorsal sensory branch of the ulnar nerve, is presented.
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Frank
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: William
authors.initials: W
authors.lastname: Slikker
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Laith
authors.initials: L
authors.lastname: Al-Shihabi
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Wysocki