Reconstruction of Chronic Foveal TFCC Tears with an Autologous Tendon Graft

Gregory I. Bain; Kevin Eng; Yu Chao Lee; Duncan Mcguire; Matthias Zumstein

doi:10.1055/s-0034-1399756

Journal of Wrist Surgery, Table of Contents

J Wrist Surg 2015; 04(01): 009-014
DOI: 10.1055/s-0034-1399756

Special Focus Section: Foveal Tears of the TFCC

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Reconstruction of Chronic Foveal TFCC Tears with an Autologous Tendon Graft

Gregory I. Bain

¹Department of Orthopaedic Surgery, Flinders University of South Australia, South Australia, Australia

,

Kevin Eng

²Barwon Orthopaedic Research Unit, Geelong University Hospital. Geelong, Victoria, Australia

,

Yu Chao Lee

³Department of Orthopaedic Surgery, Modbury Public Hospital, Adelaide, Australia

,

Duncan Mcguire

⁴Department of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa

,

Matthias Zumstein

⁵Upper Extremity Unit, Department of Orthopaedic Surgery Traumatology, University of Bern, Inselspital, Bern, Switzerland

› Author Affiliations

Abstract

Background A triangular fibrocartilage complex (TFCC) injury can produce distal radioulnar joint (DRUJ) instability. If the foveal attachment is avulsed, it translates distally. The footprint is separated from its origin and will become covered in synovitis, preventing healing. The authors describe a surgical technique for the treatment of instability of the DRUJ due to chronic foveal detachment of the TFCC.

Technique The procedure utilizes a loop of autologous palmaris longus tendon graft passed through the ulnar aspect of the TFCC and through an osseous tunnel in the distal ulna to reconstruct the fovel attachment.

Patients and Methods We report on nine patients with a mean age of 42. Median follow-up was 13 months.

Results The median pain scores measured were reduced from 8 to 3 postoperatively, and all had a stable DRUJ.

Conclusions This technique provides stability of the distal ulna to the radius and carpus, with potential for biologic healing through osseous integration. It is a robust, anatomically based reconstruction of the TFCC to the fovea that stabilizes the DRUJ and the ulnar-carpal sag.

Keywords

triangular fibrocartilage complex - foveal tear - DRUJ instability

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References

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