Nerve Fiber Staining Investigations in Traumatic and Degenerative Disc Lesions of the Wrist

Unglaub, Frank; Wolf, M.; Dragu, Adrian; Schwarz, Stephan; Kroeber, Markus; Horch, Raymund E.

doi:10.1016/j.jhsa.2010.12.029

Cited by 3 publications

(1 citation statement)

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“…However, when they investigated 1A lesions, none of the 32 patients showed ingrowth of fibers in biopsy stains. 53 The literature to date however does support that a portion of patients treated conservatively continue to have pain and are unable to return to activities or work. Park et al reported this number as high as 43%, 26 but no other articles discuss the prevalence of work restriction or agree on the length of time to trial conservative therapy.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Analysis of Palmer Type I Triangular Fibrocartilage Complex Injuries: Outcomes of Treatment

McNamara

Colakoğlu

Iorio

2020

Journal of Hand and Microsurgery

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Triangular fibrocartilage complex (TFCC) injuries can present incidentally as an asymptomatic lesion or can cause acute and chronic pain. This study compared different treatment approaches for symptomatic Palmer Type 1 TFCC injuries and rates of improvement using a systematic review of the literature. Two hundred thirty-one articles were identified, 43 met criteria and were included. Two of these articles indicated conservative therapy may be adequate. Patients who underwent debridement for any Type 1 Palmer class returned to work at a rate of 92% (n = 182), but only 44% (n = 38) were free of pain. For 1B lesions that underwent repair, 68.3% (n = 226) were able to return to work and 41% (n = 52) had persistent pain. 1D lesions were treated with both repair and debridement with similar results. Data for Types 1A and 1C were limited as no authors solely addressed these lesions. For 1A lesions, those treated with traditional treatment of debridement still had high rates of being unable to return to work. The literature remains insufficient, making comparison between studies and techniques difficult. For asymptomatic injuries, there is no need for treatment. For patients with recalcitrant symptoms, surgery improves pain, grip strength, and increases return to work and activity. The level of evidence is IV.

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Section: Discussionmentioning

confidence: 99%

A Systematic Review and Analysis of Palmer Type I Triangular Fibrocartilage Complex Injuries: Outcomes of Treatment

McNamara

Colakoğlu

Iorio

2020

Journal of Hand and Microsurgery

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Update TFCC: histology and pathology, classification, examination and diagnostics

Kirchberger

Unglaub

Mühldorfer-Fodor

et al. 2015

Arch Orthop Trauma Surg

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The TFCC is a crucial stabilizer of the DRUJ. Based on its superficial and deep fibers, the TFCC guarantees unrestricted pronation and supination which is essential for performing sophisticated tasks. The ability to perform complex movements is of uppermost importance for hand function. Therefore, a functional intact TFCC is a prerequisite in this context. The articular disc of the TFCC is a fibrocartilaginous extension of the superficial zone of hyaline articular cartilage which arises from the radius. The peripheral 10-40 % of the TFC is vascularized. Degeneration of the articular disc is common with increasing age. Even though the central part of the articular disc is avascular, potential regeneration of lesions could be detected. The Palmer and Atzei classifications of TFCC lesions are complementary. TFCC innervation is based on different nerves. There is a high variability. A diligent clinical examination facilitates specific tests which help to allocate symptoms to the pathology. Therefore, a thorough clinical examination is not dispensable. Wrist arthroscopy remains the "gold standard" for diagnosing TFCC pathologies despite technical progress in imaging modalities. MR arthrography may have the potential to become a real alternative to wrist arthroscopy for diagnosing TFCC pathologies with technical progress in the future.

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Nerve Fiber Staining Investigations in Traumatic and Degenerative Disc Lesions of the Wrist

Cited by 3 publications

References 20 publications

A Systematic Review and Analysis of Palmer Type I Triangular Fibrocartilage Complex Injuries: Outcomes of Treatment

A Systematic Review and Analysis of Palmer Type I Triangular Fibrocartilage Complex Injuries: Outcomes of Treatment

Update TFCC: histology and pathology, classification, examination and diagnostics

Bibliography Current World Literature

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