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Stability and Pain Relief After Arthroscopic Transosseous Repair Of The Triangular Fibro-Cartilage Complex (TFCC)
Eva-Maria Baur, MD
Practice for Plastic and Hand Surgery, Murnau, Germany

The TFCC stabilizes not only the ulno-carpal joint but also the distal radio-ulnar joint (DRUJ). Injuries of the TFCC normally lead to pain and depending on the type of the lesion to instability of the DRUJ. One important aspect of this instability is the foveal detachment of the TFCC at the base of the processus styloideus ulnae (PSU). Foveal ruptures of the TFCC are detectable during arthroscopic treatment (positive "hook" test). Nakamura proposed an arthroscopic transosseous refixation of the TFCC. From 2007 to 2013 we treated 61 patients in a slight modification of the manner described by Nakamura. In opposite to the common recommendation we treated chronic (>6 month) ruptures of the TFCC as well. We examined 39 patients with the modified Mayo-Wrist- and DASH-score and checked clinically the stability of the DRUJ. The minimal postoperative time range was 12 months. The questionnaire revealed no obvious difference between acute and chronic TFCC lesions after surgery. Almost every patient showed good stability of the DRUJ and satisfying to good pain relief after the treatment. Regarding our results we can recommend the arthroscopic assisted transosseous refixation of the TFCC (Nakamura's tecnic) as a good option in the operative treatment of acute as well in chronic lesiones of the TFCC and DRUJ instability.

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