Arthroskopisch unterstützte ulnare Refixierung des TFCC mit Schraubanker

Schmelzer-Schmied, N.

doi:10.1007/s00064-016-0455-7

Cited by 10 publications

(11 citation statements)

References 13 publications

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“…2 3 4 5 6 7 En pacientes con lesiones de esta estructura y que, pese a tratamiento médico, se mantienen sintomáticos y con una articulación RUD inestable, es necesario realizar una reinserción de la porción foveal del CFCT a la ulna distal para recuperar una correcta biomecánica de la muñeca y así disminuir el dolor y mejorar la función global. 4 8 11 12 13 14 15 16 17…”

Section: Discussionunclassified

“…[2][3][4][5][6][7] In patients with lesions of this structure and who, despite medical treatment, remain symptomatic and with an unstable DRU joint, it is necessary to perform a reinsertion of the foveal portion of the TFCC to the distal ulna to recover the correct biomechanics of the wrist and thus reduce pain and improve overall function. 4,8,[11][12][13][14][15][16][17] Currently, arthroscopic techniques have become very important, since, as a result of the magnification and implementation of small instruments, it enables an accurate diagnosis of these injuries. 4,8 In addition, they enable the performance of advanced techniques that have shown clinical results similar to those of open techniques, and with even better results in terms of the remaining ulnar pain.…”

Section: Discussionmentioning

confidence: 99%

“…12 Within the fixation options of the foveal portion to the distal ulna, the most commonly used methods are reinsertion with bone anchors (RAs) and reinsertion with sutures through transosseous tunnels (TOs). 4,8,[14][15][16][17] Both techniques have shown satisfactory results, 4,8,[14][15][16][17] but no studies comparing them have not been found in the international literature.…”

Section: Introductionmentioning

confidence: 99%

“…Dentro de las opciones de fijación de la porción foveal a la ulna distal, los métodos más utilizados son la reinserción con anclaje (RA) óseo y la reinserción con suturas por medio de túneles transóseos (TOs). 4 8 14 15 16 17 Ambas técnicas han demostrado resultados satisfactorios, 4 8 14 15 16 17 y no se encuentran en la literatura internacional estudios comparativos.…”

Section: Introductionunclassified

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Arthroscopically-Assisted Foveal Repair of the Triangular Fibrocartilage Complex: Anchor Fixation versus Trans Osseous Tunnel – A Comparative Study

Azócar

Cifras

Montenegro

et al. 2022

Revista Iberoamericana de Cirugía de la Mano

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Introduction The triangular fibrocartilage complex (TFCC) plays a fundamental role in the stability of the wrist, and its foveal insertion is the primary structure that performs this function. Surgical repair of the CFCT is challenging given the complexity of the anatomical structures, and arthroscopically-assisted reinsertion has shown certain benefits. The most commonly used techniques are reinsertion with anchors (RAs) and transosseous tunnels (TOs). Objective To compare the functional results of patients with acute foveal lesion of the CFCT operated through RAs versus TOs, both with arthroscopic assistance. Materials and methods A retrospective, observational study of patients operated on for foveal disinsertion of the TFCC. We included patients older than 18 years of age, with a traumatic history and conservative treatment lsting 3 months, with persistent pain and arthro-computed tomography (arthroCT) compatible with foveal disinsertion of the TFCC. Patients treated with the RA technique versus TOs were compared, both with arthroscopic assistance. The variables studied were pain during load according to the visual analog scale (VAS), Mayo score, and ranges of motion of the wrist. Values of p <0.05 were considered statistically significant. Results We included 24 patients (11 in the RAs group and 13 in the TOs group) With an average age of 28.5 years, 58% of whom were male, without statistically significant differences between the groups. In the whole sample, a decrease in pain of 4.33 points (standard deviation [SD]: 1.16) on the VAS was found, with no statistically significant differences between the groups (p = 0.98). The Mayo score improved in both groups, with an average of 30.09 points (SD: 0.94) in the RAs group, and 31.92 points (SD: 1.32) in the TOs group, and this difference was statistically significant (p = 0.0004). Flexion-extension increased by 5.2° (SD: 2.3°) in the RAs group, and by 6.9° (SD: 1.32°) in the TOs group, and this difference was also statistically significant (p = 0.01). Pronation improved by 15.9° (SD: 1.7°) in the RAs group, and by 15.8° (SD: 1.72°) in the TOs group, which was not statistically significant (p = 0.46), and supination improved by 17.09° (SD: 2.46°) in the RAs group, and by 17.5° (SD: 1.61°) in the TOs group, which was statistically significant (p = 0.004).The mean duration of ischemia was of 34.2 minutes (SD: 4.36 minutes) in the TOs group, and of 78.9 minutes (SD: 9.39 minutes) in the RAs group, and this difference was statistically significant (p = 0.000). Discussion In the surgery for foveal reinsertion of the TFCC, both the techniques with anchors and with TOs, are effective in reducing load-bearing pain, improving the ranges of motion of the joints and the functional score. Although we found statistically significant differences between the groups regarding the Mayo score, flexion-extension and supination, these do not exceed the minimally-significant clinical differences. Conclusion Both techniques are effective in reducing weight bearing pain and improving function and range of motion of the wrist. TO surgery has a significantly shorter ischemia time than RA surgery.

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Section: Discussionunclassified

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionunclassified

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Arthroscopically-Assisted Foveal Repair of the Triangular Fibrocartilage Complex: Anchor Fixation versus Trans Osseous Tunnel – A Comparative Study

Azócar

Cifras

Montenegro

et al. 2022

Revista Iberoamericana de Cirugía de la Mano

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“…Für die arthroskopisch gestützte Refixation der radioulnaren Bänder in der Fovea werden transossäre Nähte mit und ohne Zielgerät [15] und Nahtankersysteme [16] eingesetzt. Die Nähte sind so zu platzieren, dass sie in belastbarem, d. h. nicht degenerativ verändertem Gewebe des TFCC verankert werden.…”

Section: Therapieunclassified