title: [Arthroscopically assisted transcapsular refixation of the triangular fibrocartilage complex of the wrist].
abstract: OBJECTIVE
  Refixation of the triangular fibrocartilage complex (TFCC) to the ulnar capsule of the wrist.
  
  
  METHODS
  Distal TFCC tears without instability, proximal TFCC intact. Loose ulnar TFCC attachment without tear or instability.
  
  
  METHODS
  Peripheral TFCC tears with instability of the distal radioulnar joint (DRUJ). Complex or proximal tears of the TFCC. Isolated, central degenerative tears without healing potential.
  
  
  METHODS
  Arthroscopically guided, minimally invasive suture of the TFCC to the base of the sixth extensor compartment.
  
  
  METHODS
  Above elbow plaster splint, 70° flexion of the elbow joint, 45° supination for 6 weeks. Skin suture removal after 2 weeks. No physiotherapy to extend pronation and supination during the first 3 months.
  
  
  RESULTS
  In an ongoing long-term study, 7 of 31 patients who underwent transcapsular refixation of the TFCC between 1 January 2003 and 31 December 2010 were evaluated after an average follow-up interval of 116 ± 34 months (range 68-152 months). All patients demonstrated an almost nearly unrestricted range of wrist motion and grip strength compared to the unaffected side. All distal radioulnar joints were stable. On the visual analogue scale (VAS 0-10), pain at rest was 1 ± 1 (range 0-2) and pain during exercise 2 ± 2 (range 0-5); the DASH score averaged 10 ± 14 points (range 0-39 points). All patients were satisfied. The modified Mayo wrist score showed four excellent, two good, and one fair result. These results correspond to the results of other series.
  
  
  CONCLUSIONS
  Transcapsular refixation is a reliable, technically simple procedure in cases with ulnar-sided TFCC tears without instability leading to good results.
authors: Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland. t.pillukat@handchirurgie.de.
authors: T
authors: T
authors: Pillukat
authors: Klinik für Fußchirurgie, Bad Neustadt an der Saale, Deutschland.
authors: R A
authors: RA
authors: Fuhrmann
authors: Klinik für Unfall- und Handchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.
authors: J
authors: J
authors: Windolf
authors: Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland.
authors: J
authors: J
authors: van Schoonhoven
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods; D013536:Suture Techniques; D016896:Treatment Outcome; D051478:Triangular Fibrocartilage / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D014954:Wrist Injuries / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult
keywords: Arthroscopy; Joint capsule; Joint instability; Minimally invasive surgery; TFCC tear