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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2021; 49(02): e97-e104
DOI: 10.1055/s-0041-1736570
Original Article | Artículo Original

Anatomic Reconstruction of the Triangular Fibrocartilage Complex for the Treatment of Chronic Instability of the Distal Radioulnar Joint. A Systematic Review

Article in several languages: English | español
Ignacio Miranda 
1   Orthopedic Surgery and Traumatology Service, Hospital Arnau de Vilanova, Valencia, España
,
Francisco J. Lucas 
2   Hand and Upper Limb Surgery Unit, Hospital Quirónsalud Valencia, Valencia, España
,
Vicente Carratalá 
2   Hand and Upper Limb Surgery Unit, Hospital Quirónsalud Valencia, Valencia, España
,
Joan Ferràs-Tarragó 
1   Orthopedic Surgery and Traumatology Service, Hospital Arnau de Vilanova, Valencia, España
,
Francisco J. Miranda 
3   Department of Physiology, Universitat de València, Valencia, España
› Author Affiliations Source of Funding The authors have no source of funding to declare.
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Abstract

Introduction Peripheral injuries of the triangular fibrocartilage complex (TFCC) can produce pain and instability of the distal radioulnar joint (DRUJ). There are several techniques for the reconstruction of the TFCC. The aim of the present paper was to summarize the tendon plasties of the DRUJ ligaments for the anatomic reconstruction of TFCC, to analyze the surgical techniques, and to evaluate their outcomes.

Methods In order to perform a systematic review, we searched in the literature the terms DRUJ instability OR chronic distal radioulnar joint instability OR distal radioulnar tendon plasty.

Results In total, 11 articles with level of evidence IV (case series) were retrieved. Most studies achieved good results, with recovery of wrist stability, improvement of the pain, and increase in grip strength in the functionality tests. In the historical evolution of the published series, wrist surgeons tried to perform a more anatomical plasty, with a more stable fixation and less invasive techniques.

Conclusion The Adams procedure continues to be a valid and reproducible technique for the treatment of chronic DRUJ instability. If wrist arthroscopy and implants are available and surgeons have been technically trained, the authors recommend an arthroscopy-assisted technique, or, if possible, an all-arthroscopic TFCC reconstruction with implant fixation of the plasty in its anatomical points of insertion. Comparative studies between open and arthroscopic TFCC reconstruction techniques are needed.

Keywords

chronic distal radioulnar joint instability - triangular fibrocartilage complex - tendon plasty - reconstruction of distal radioulnar ligaments


Publication History

Received: 26 October 2020

Accepted: 31 March 2021

Article published online:
13 December 2021

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