Results after arthroscopic treatment of central traumatic lesions of the triangular fibrocartilage complex

Arsalan-Werner, Annika; Grüter, LM; Mehling, Isabella; Moll, Wibke; Wölfle, O.; Sauerbier, Michael

doi:10.1007/s00402-018-2910-4

Cited by 20 publications

(38 citation statements)

References 32 publications

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“…Arsalan-Werner et al evaluated the clinical outcome of 43 patients with symptomatic TFCC Palmer type 1A lesions following arthroscopic debridement with a mean follow-up of 42.5 months. Motion pain and pain at rest improved significantly from 8.4 ± 1.6 to 2.6 ± 2.1, and 7.2 ± 2 to 1.4 ± 1.6, respectively [17]. Cardenas-Montemayor et al determined functional and subjective results of 31 patients who received arthroscopic debridement for TFCC Palmer type 1B lesions with a mean follow-up of 26.7 months.…”

Section: Discussionmentioning

confidence: 99%

“…The degree of pronation and supination is a relevant indicator for the TFCC constitution and DRUJ stability [18,21]. Arsalan-Werner et al evaluated pronation with 98.4%, and supination with 95.6% of the contralateral side [17]. In the study by Cardenas-Montemayor et al, the postoperative pro-/supination ROM averaged 99.4% when compared with the contralateral wrist [18].…”

Section: Discussionmentioning

confidence: 99%

“…TFCC lesions are often associated with decreased grip strength and its adequate restoration is a primary treatment goal [16]. Arsalan-Werner et al demonstrated a significant reduction of grip strength after surgery with 79.6% of the contralateral wrist [17]. In the study of Cardenas-Montemayor et al grip strength was 96.7% of the contralateral side [18].…”

Section: Discussionmentioning

confidence: 99%

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Outcome of conservative treatment for triangular fibrocartilage complex lesions with stable distal radioulnar joint

Sander

Sommer

Kaiser

et al. 2020

Eur J Trauma Emerg Surg

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Purpose Triangular fibrocartilage complex (TFCC) lesions have high clinical relevance. Although multiple studies have been done in the past, there is a lack of data after conservative treatment and controversy remains regarding management. The purpose of this study was to compare the outcome of symptomatic TFCC lesions after conservative treatment and arthroscopic debridement. Methods Between 2012 and 2017, 33 patients were included. 16 patients were treated conservatively and 17 patients with arthroscopic debridement. The average age was 41 years (range 18-63). The mean follow-up was 22.2 months (range 6-74). Evaluation included pain, range of motion (ROM), grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Modified Mayo Wrist Score (MMWS), and Purdue Pegboard test. Results Pain averaged 0.1 (range 0-1) in the conservative group compared to 1.3 (range 0-6) in the arthroscopic group. The mean ROM was 99% for wrist extension, and 100% for flexion and pro-/supination in the conservative group, and 96% for extension and flexion, and 100% for pro-/supination in the arthoscopic group compared to the contralateral side. Grip strength was 88% (range 63-100) in the conservative group versus 89% (range 33-100) in the arthroscopic group. The conservative group reached a DASH score of 16.8 and MMWS of 94.3 compared to 22.1 and 87.2 in the arthroscopic group. The differences were not statistically significant. Conclusions Our study demonstrated similar results of conservative compared to arthroscopic treatment. Because conservative treatment was a sufficient and reliable option, we propose it as first-line treatment for TFCC lesions with stable distal radioulnar joint.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outcome of conservative treatment for triangular fibrocartilage complex lesions with stable distal radioulnar joint

Sander

Sommer

Kaiser

et al. 2020

Eur J Trauma Emerg Surg

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“…In this analysis, 302 patients underwent TFCC debridement in 10 articles of a variety of Palmer types (178 1A, 53 1B, 14 1C, 28 1D with 43 unclassified Type 1) which were not separated for results and sometimes represent multiple lesions in the same patient. 9,15,[29][30][31][32][33][34][35][36] All were done arthroscopically. Three of these articles used the Mayo wrist classification to evaluate patient outcomes, and among the 75 patients in these studies, 30 patients demonstrated excellent, 29 good, 9 fair, and 7 poor outcomes.…”

Section: Debridementmentioning

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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“…TFCC-Läsion (▶ Tab. 1, Box Zusatzinfo) [9,27]. Die Patienten beschreiben meist Beschwerden beim "Auswringen" eines Handtuchs, bei Nutzung eines Schraubenziehers, bei Unterarmdrehbewegung und bei Kraftanstrengung.…”

Section: Symptomatikunclassified

Die Behandlung des ulnokarpalen Impaktionssyndroms

Terzis¹,

Neubrech²,

Sebald³

et al. 2019

Handchir Scan

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Results after arthroscopic treatment of central traumatic lesions of the triangular fibrocartilage complex

Abstract: Therapeutic, level IV.

Cited by 20 publications

References 32 publications

Outcome of conservative treatment for triangular fibrocartilage complex lesions with stable distal radioulnar joint

Outcome of conservative treatment for triangular fibrocartilage complex lesions with stable distal radioulnar joint

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

Die Behandlung des ulnokarpalen Impaktionssyndroms

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