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TFCC Injuries in Elite Athletes: Implications and Expectations
Abdo Bachoura, MD1; Lee Diprinzio, BS1; Blane Sessions, MD2; Sidney Jacoby, MD3; A. Lee Osterman4; Randall W. Culp, MD1;
1Thomas Jefferson University, 2Philadelphia Hand Center, 3Thomas Jefferson University Hospital, 4The Philadelphia Hand Center, Thomas Jefferson University

Introduction: Triangular Fibrocartilage Complex (TFCC) injuries typically present as ulnar-sided wrist pain that increases with activity. This injury can be particularly debilitating in athletes secondary to pain, decreased grip strength and diminution of the athletic response. The purpose of this study was to determine the short-term impact of TFCC injuries in professional athletes from a variety of sports.

Materials & Methods: A retrospective chart review was performed on all professional athletes treated at one surgical center between 2000 until 2012. The primary inclusion criteria was 1) a diagnosis of TFCC tear related to sport activities and 2) status as an active, professional athlete. Patient demographics, mechanism of injury, surgical treatment and outcome were collected from the medical records. Information on return to play was collected from the internet when applicable.

Results: There were 12 male patients (3 Baseball players, 7 Hockey players, 1 Football player and 1 Basketball player) diagnosed with TFCC tears. Five patients had concomitant ulnar extrinsic injury. The mean age was 25.0 (20-30) years. Ten patients underwent 12 procedures at our center and two patients elected non-operative treatment. The patients that were treated non-operatively (1 NBA and 1 MLB) missed the 3 last games of the season and 25 games respectively. They were both able to continue professional sports without surgery. Among the operative group of patients, eight surgeries consisted of arthroscopic TFCC repair while three consisted of arthroscopic debridement. The mean time between injury and surgery was 5.6 months (0-22). One complication occurred in one patient who experienced a painful retained suture. Six NHL hockey players and 1 NFL linebacker played with the injury throughout the season, and were surgically treated once the season ended. All returned to play at the start of the next season. One minor league baseball player missed two seasons and one minor league baseball player did not return to play after the injury.

Conclusion: The level of dependence on hand and wrist motion varies among different sports and this has a direct impact on the playing ability of professional athletes. While professional hockey and football players are able to cope and play with this particular injury (opting for delayed definitive treatment), baseball and basketball players are more likely to miss time during the season.

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