Arthroscopic Triangular Fibrocartilage Complex Reconstruction Using a Palmaris Longus Tendon Graft.


Journal

Techniques in hand & upper extremity surgery
ISSN: 1531-6572
Titre abrégé: Tech Hand Up Extrem Surg
Pays: United States
ID NLM: 9704676

Informations de publication

Date de publication:
01 Jun 2022
Historique:
pubmed: 20 8 2021
medline: 18 6 2022
entrez: 19 8 2021
Statut: epublish

Résumé

Patients suffer from persistent ulnar wrist pain and distal radioulnar joint instability because of chronic triangular fibrocartilage complex (TFCC) foveal tear are treated with TFCC reconstruction. We performed an arthroscopic TFCC reconstruction using a palmaris longus tendon graft that provided a minimally invasive procedure. After confirming the TFCC foveal tear and stability between the TFCC remnant and radius, the bone tunnel was made in the ulna from the ulnar shaft to ulnar fovea. The position of the bone tunnel was checked by fluorography and arthroscopy. Curved bendable 18-gauge needles into which 3-0 nylon sutures were inserted in a loop shape were passed through the tunnel from the ulnar side, and both volar-side and dorsal-side TFCC remnants were penetrated. The nylon suture was extracted from the arthroscopic 4/5 portal, and the palmaris longus tendon graft was introduced into the joint. The graft was passed through the TFCC remnant and ulnar bone tunnel from the arthroscopic portal and fixed to the ulna using an interference screw. This procedure was indicated for TFCC foveal tears with intact radial-side TFCC remnants. If the radial-side tear and instability between the TFCC and radius coexist, this technique is contraindicated, and stabilization of both the radial and ulnar sides of the TFCC should be considered. This arthroscopic technique does not violate the distal radioulnar joint capsule, extensor carpi ulnaris tendon, or tendon sheath. In addition, it helps to stabilize the ulnar carpal complex.

Identifiants

pubmed: 34411040
doi: 10.1097/BTH.0000000000000365
pii: 00130911-202206000-00006
doi:

Substances chimiques

Nylons 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

93-97

Informations de copyright

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding.

Références

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Schuind F, An KN, Berglund L, et al. The distal radioulnar ligaments: a biomechanical study. J Hand Surg Am. 1991;16:1106–1114.
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Adams BD, Berger RA. An anatomic reconstruction of the distal radioulnar ligaments for posttraumatic distal radioulnar joint instability. J Hand Surg Am. 2002;27:243–251.
Bain GI, McGuire D, Lee YC, et al. Anatomic foveal reconstruction of the triangular fibrocartilage complex with a tendon graft. Tech Hand Up Extrem Surg. 2014;18:92–97.
Palmer AK. Triangular fibrocartilage complex lesions: a classification. J Hand Surg. 1989;14:594–606.
Atzei A, Luchetti R. Foveal TFCC tear classification and treatment. Hand Clin. 2011;27:263–272.
Potter HG, Asnis-Ernberg L, Weiland AJ, et al. The utility of high-resolution magnetic resonance imaging in the evaluation of the triangular fibrocartilage complex of the wrist. J Bone Joint Surg Am. 1997;79:1675–1684.
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Auteurs

Shingo Abe (S)

Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, Toyonaka.

Toshiyuki Kataoka (T)

Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, Toyonaka.
Department of Orthopedic Surgery, Sakai City Medical Center, Sakai.

Rie Suzuki (R)

Department of Orthopedic Surgery, Osaka International Cancer Institute, Chuuouku.

Yukihiko Yasui (Y)

Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, Toyonaka.
Department of Orthopedic Surgery, JCHO Hoshigaoka Medical Center, Hirakata, Osaka, Japan.

Kohji Kuriyama (K)

Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, Toyonaka.

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