J Korean Soc Surg Hand.  2013 Jun;18(2):85-94. 10.12790/jkssh.2013.18.2.85.

Current Treatment of Triangular Fibrocartilage Complex Injuries

• Kim BS

• KMID: 2194163
• DOI: http://doi.org/10.12790/jkssh.2013.18.2.85

Abstract

The Palmer class 1B triangular fibrocartilage complex injury has two entities: a lesion with stable distal radioulnar joint and a lesion with distal radioulnar joint instability. Arthroscopic debridement of fibrocartilage disk is used in Palmer class 1A lesion. The surgeon should remove the portion of the fibrocartilage tissue until a mechanically stable and smooth residual rim remains. Arthroscopic repair is used in Palmer class 1B or 1D lesion using meniscal repair sutures. Ulnar detachment that can produce distal radioulnar ligament instability can also be repaired using bone anchor or pull out suture. Old age as well as positive ulnar variance is poor prognostic factors.

Keyword

Triangular fibrocartilage complex; Distal radioulnar joint; Arthroscopy

MeSH Terms

Arthroscopy
Debridement
Fibrocartilage
Joint Instability
Joints
Ligaments
Suture Anchors
Sutures
Triangular Fibrocartilage

Figure

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  Fig. 1. Magnetic resonance imaging and dynamic ultrasonography findings of extensor carpi ulnaris tendon instability.

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  Fig. 2. Magnetic resonance imaging findings of triangular fibrocartilage complex foveal avulsion with distal radioulnar joint instability.

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  Fig. 3. Arthroscopic findings seen from distal radioulnar joint portal.

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  Fig. 4. Arthroscopic debridement for Plamer type 1A tear.

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  Fig. 5. Arthroscopic repair for Plamer type 1B tear using direct foveal portal.

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  Fig. 6. Radiographs after ulnar shortening osteotomy.

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