PubMed | Modbury Public Hospital, Geelong University Hospital Geelong, University of South Australia, University of Bern and Groote Schuur Hospital
Type: Journal Article | Journal: Journal of wrist surgery | Year: 2015
BackgroundA 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. TechniqueThe 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 MethodsWe report on nine patients with a mean age of 42. Median follow-up was 13 months. ResultsThe median pain scores measured were reduced from 8 to 3 postoperatively, and all had a stable DRUJ. ConclusionsThis 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.