Triangular fibrocartilage complex (TFCC) repair
Overview
The triangular fibrocartilage (TFCC) is an important ligament in the ulnar wrist that plays an essential role in maintaining stability of the wrist joint. TFCC is commonly injured by both trauma and degeneration.
Traumatic injury often involves falling on an extended wrist or a with a forceful twisting motion of the wrist. Acute injuries can usually be treated conservatively while injuries more than 4 weeks have a hard time healing by itself.
On the other hand, degenerative tear of the TFCC are often a result of idiopathic ulnar plus morphology and repeated ulnocarpal impaction causing tissue wear.
Features
To restore the stability of the wrist joint, TFCC repair surgery has evolved through the years and became a well-established procedure. Arthroscopic TFCC repair has become the mainstream treatment method in recent years. While there is ongoing debate regarding whether capsular repair, suture anchor, or transosseous tunnel repair yields the most satisfying outcome, all these methods have been reported in literature with good results.
Procedure
TFCC repair is performed arthroscopically in our facility with a 1.9mm scope. Standard examination, shaving and joint preparation are performed first. TFCC repair is performed with suture anchor repair or capsulorrhaphy according to the patient’s decision after consulting with the attending surgeon.
Whether ulnar shortening is necessary depends on the different circumstances in each case scenario and should be discussed with the attending surgeon.
Notification
- Rehabilitation: After the procedure, 4 weeks of protective splint use is mandatory and range of motion exercise will be initiated afterwards. The estimated recovery to normal activity level is approximately 12 weeks.
- Complications: The most common complications of this procedure include transient ulnar nerve neurapraxia (<2%), knot irritation (more common in capsulorrhaphy, but also <2%) and superficial infection (<0.5%).
Estimated Cost
For estimated medical costs, please contact International Medical Services Center.