scholarly journals Prevalence of Triangular Fibrocartilage Complex Abnormalities Regardless of Symptoms Rise With Age: Systematic Review and Pooled Analysis

2014 ◽  
Vol 472 (12) ◽  
pp. 3987-3994 ◽  
Author(s):  
Jimmy J. Chan ◽  
Teun Teunis ◽  
David Ring
Keyword(s):  
Systematic Review ◽  
Pooled Analysis ◽  
Triangular Fibrocartilage Complex ◽  
Triangular Fibrocartilage

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

2021 ◽  
Vol 49 (02) ◽  
pp. e97-e104
Author(s):  
Ignacio Miranda ◽  
Francisco J. Lucas ◽  
Vicente Carratalá ◽  
Joan Ferràs-Tarragó ◽  
Francisco J. Miranda
Keyword(s):  
Systematic Review ◽  
Surgical Techniques ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Anatomic Reconstruction ◽  
Wrist Arthroscopy ◽  
Radioulnar Joint ◽  
Druj Instability ◽  
Triangular Fibrocartilage

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.

scholarly journals Arthroscopic Treatment Results of Triangular Fibrocartilage Complex Tears in Adolescents: A Systematic Review

2021 ◽  
Vol 10 (11) ◽  
pp. 2363
Author(s):  
Florian Schachinger ◽  
Sebastian Farr
Keyword(s):  
Systematic Review ◽  
Return To Sport ◽  
Sports Participation ◽  
Triangular Fibrocartilage Complex ◽  
Wrist Pain ◽  
Arthroscopic Treatment ◽  
Wrist Arthroscopy ◽  
Cochrane Central Register ◽  
Level Of Evidence ◽  
Triangular Fibrocartilage

Introduction: Injury to the triangular fibrocartilage complex (TFCC) may cause chronic wrist pain and instability if left untreated. The current literature of adult cases suggests that arthroscopic treatment offers favorable outcomes and is associated with a low complication rate. This systematic review evaluated the outcomes of arthroscopic TFCC surgery in adolescents. Materials and Methods: A PRISMA-guided literature search of PubMed, Medline, Embase, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Cochrane Clinical Answers was conducted in May 2020. All studies reporting on (1) arthroscopic TFCC repair or debridement in (2) patients under the age of 19 years with (3) a minimum case number of four patients were extracted by two independent observers. The level of evidence of each study was assessed according to the Oxford Centre for Evidence-Based Medicine, and study quality was graded according to the Modified Coleman Methodology Score and the MINORS criteria. Clinical outcome scores, functional parameters, and any complications were reviewed. Results: The selected search terms initially resulted in a total of 986 possible articles. The authors eventually identified eight papers (all LoE IV) for inclusion in this systematic review. A total of 254 patients with verified TFCC tears and a mean age of 16 years (range, 7–19) received arthroscopic repair (162 patients, 67.1% of total) or debridement (77 patients, 29.7% of total). Arthroscopic treatment resulted in low pain levels, high patient satisfaction, and a fast return to sport. Complications overall were sparse and consisted mainly of persistent wrist pain (n = 31) and temporary paresthesia (n = 6) of the dorsal sensory branch of the ulnar nerve. Recurrent tears were sparse, with only four reported cases due to sports participation. Conclusion: Wrist arthroscopy is a reliable surgical option for treating TFCC tears in adolescents. The results obtained are comparable to those published in the literature. However, the variety of repair techniques and the low level of evidence across all included articles demand further prospective studies.

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

2020 ◽  
Vol 12 (02) ◽  
pp. 116-122
Author(s):  
Colin T. McNamara ◽  
Salih Colakoglu ◽  
Matthew L. Iorio
Keyword(s):  
Systematic Review ◽  
Return To Work ◽  
Conservative Therapy ◽  
Triangular Fibrocartilage Complex ◽  
Type I ◽  
Level Of Evidence ◽  
Traditional Treatment ◽  
Need For Treatment ◽  
Triangular Fibrocartilage

AbstractTriangular 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.

scholarly journals Open Versus Arthroscopic Repair of 1B Ulnar-Sided Triangular Fibrocartilage Complex Tears: A Systematic Review

Hand ◽  
2019 ◽  
Vol 15 (4) ◽  
pp. 456-464
Author(s):  
Vanessa Robba ◽  
Andrew Fowler ◽  
Alexia Karantana ◽  
Douglas Grindlay ◽  
Tommy Lindau
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Open Repair ◽  
Secondary Analysis ◽  
Triangular Fibrocartilage Complex ◽  
Arthroscopic Repair ◽  
Secondary Outcome ◽  
Inclusion Criteria ◽  
Druj Instability ◽  
Triangular Fibrocartilage

Background: Peripheral 1B tears of the triangular fibrocartilage complex (TFCC) can result in distal radioulnar joint (DRUJ) instability. In the context of associated DRUJ instability, combined evidence supports successful outcomes for peripheral tear repair. Methods: The aim of this systematic review (SR) was to compare the surgical treatment of 1B TFCC tears via arthroscopic versus open methods of repair. The primary outcome measure was restored DRUJ stability. The secondary outcome measures included patient-reported outcomes and clinical outcome measures. An electronic database search of Ovid Embase, PubMed, and the Cochrane Central Register of Controlled Trials was performed to cover a 20-year period. Two authors independently screened records for eligibility and extracted data. Results: Only 3 studies met the strict inclusion criteria, highlighting the poor evidence base for TFCC 1B repairs. Hence, a “secondary analysis” group was developed with modified inclusion criteria which included a further 7 studies for analysis. Pooled data from the primary and secondary analysis groups demonstrated that postoperative DRUJ stability was achieved following open repair in 84% (76/90) of cases and following arthroscopic repair in 86% (129/150) of cases. Conclusions: This SR demonstrates a current lack of high-quality evidence required to draw firm conclusions on the merits of arthroscopic versus open repair of 1B TFCC tears. There is no scientific evidence to suggest superiority of one technique over the other, albeit some surgeons and authors may express a strong personal view.

scholarly journals Surgical Repair of Triangular Fibrocartilage Complex Tears: A Systematic Review

2020 ◽  
Author(s):  
Edward H. Liu ◽  
Kary Suen ◽  
Stephen K. Tham ◽  
Eugene T. Ek
Keyword(s):  
Systematic Review ◽  
Grip Strength ◽  
Surgical Repair ◽  
Triangular Fibrocartilage Complex ◽  
Current Evidence ◽  
Pain Patient ◽  
Dash Score ◽  
Pain Intensity Score ◽  
Suture Anchors ◽  
Triangular Fibrocartilage

Abstract Objective This study systematically reviews the outcomes of surgical repair of triangular fibrocartilage complex (TFCC) tears. Existing surgical techniques include capsular sutures, suture anchors, and transosseous sutures. However, there is still no consensus as to which is the most reliable method for ulnar-sided peripheral and foveal TFCC tears. Methods A systematic review of MEDLINE and EMBASE was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The focus was on traumatic Palmer 1B ulna-sided tears. Twenty-seven studies were included, including three comparative cohort studies. Results There was improvement in all functional outcome measures after repair of TFCC tears. The outcomes following peripheral and foveal repairs were good overall: Mayo Modified Wrist Evaluation (MMWE) score of 80.1 and 85.1, Disabilities of the Arm, Shoulder and Hand (DASH) score of 15.7 and 15.8, grip strength of 80.3 and 92.7% (of the nonoperated hand), and pain intensity score of 2.1 and 1.7, respectively. For peripheral tears, transosseous suture technique achieved better outcomes compared with capsular sutures in terms of grip strength, pain, Patient-Rated Wrist Evaluation (PRWE), and DASH scores (grip 85.8 vs. 77.7%; pain 1.5 vs. 2.2; PRWE 11.6 vs. 15.8; DASH 14.4 vs. 16.1). For foveal tears, transosseous sutures achieved overall better functional outcomes compared with suture anchors (MMWE 85.4 vs. 84.9, DASH 10.9 vs. 20.6, pain score 1.3 vs. 2.1), but did report slightly lower grip strength than the group with suture anchors (90.2 vs. 96.2%). Arthroscopic techniques achieved overall better outcomes compared with open repair technique. Conclusion Current evidence demonstrates that TFCC repair achieves good clinical outcomes, with low complication rates. Level of Evidence This is a Level IV therapeutic study.

Triangular Fibrocartilage Complex Repair and Ulna Variance: A Systematic Review

2018 ◽  
Vol 23 (03) ◽  
pp. 313-319 ◽  
Author(s):  
Ki Jin Jung ◽  
Jae-Hwi Nho ◽  
Jin Hyeung Kim ◽  
Byung-Sung Kim ◽  
Hyun Sik Gong
Keyword(s):  
Systematic Review ◽  
Clinical Outcome ◽  
Scoring Systems ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Ulnar Variance ◽  
Added Value ◽  
Level Of Evidence ◽  
Ulnar Shortening Osteotomy ◽  
Triangular Fibrocartilage

Background: This purpose of the study was to conduct a systematic review of available literature regarding the association between ulnar variance and outcomes after repair of peripheral traumatic tears of the triangular fibrocartilage complex (TFCC). Methods: A systematic literature search of the medical literature about peripheral tears of the TFCC was performed. We selected seven studies comparing clinical outcome and ulnar variance in patients with peripheral TFCC tears. We evaluated quality of the articles using both the Structured Effectiveness Quality Evaluation Scale (SEQES) and Sackett’s Level of Evidence (LOE). The outcomes were objective or self-assessment scoring systems for the function of the hand, wrist, or upper extremity. Results: Seven articles were evaluated. The SEQES scores varied from 19 to 28, with a mean of 23. Five studies reported no association between ulnar variance and clinical outcome, and 2 studies reported an association. The studies reporting no association either excluded or did not mention the cases of unstable distal radioulnar joint (DRUJ). Conclusions: This systematic review did not demonstrate strong evidence regarding the association between ulnar variance and outcomes after TFCC repair. As most of the studies did not distinguish between capsular and foveal tears which can affect DRUJ stability, further studies looking at this point are necessary to determine whether ulnar shortening osteotomy has an added value for better outcomes after TFCC repair.

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