Skip to main content
Erschienen in: International Orthopaedics 8/2015

01.08.2015 | Original Paper

Clinical experience with arthroscopically-assisted repair of peripheral triangular fibrocartilage complex tears in adolescents—technique and results

verfasst von: Sebastian Farr, Ulrike Zechmann, Rudolf Ganger, Werner Girsch

Erschienen in: International Orthopaedics | Ausgabe 8/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was to report our preliminary results after arthroscopically-assisted repair of peripheral triangular fibrocartilage complex (TFCC) tears in adolescent patients.

Methods

All children and adolescents who underwent arthroscopically-assisted repair of a Palmer 1B tear were identified and prospectively evaluated after a mean follow-up of 1.3 years. The postoperative assessment included documentation of clinical parameters, pain score (visual analogue scale, VAS), grip strength and completion of validated outcome scores (Modified Mayo Wrist Score, MMWS; Disabilities of the Arm, Shoulder and Hand Inventory, DASH). A total of 12 patients (four males, eight females) with a mean age of 16.3 years at the time of surgery were evaluated.

Results

The mean VAS decreased significantly from 7.0 to 1.7 after the procedure. We observed a significant increase of the MMWS after surgery; however, MMWS was still significantly lower at final follow-up when compared to the contralateral side. A mean postoperative DASH score of 16 indicated an excellent outcome after the procedure. DASH Sports and Work Modules showed fair and good overall outcomes in the short-term, respectively. Grip strength averaged 86 % of the contralateral side at final follow-up, with no significant difference being found between both sides.

Conclusions

Arthroscopically-assisted repair of peripheral TFCC tears in adolescents provided predictable pain relief and markedly improved functional outcome scores. Concomitant pathologies may have to be addressed at the same time to eventually achieve a satisfactory outcome. Sports participation, however, may be compromised in the short-term and should therefore be resumed six months postoperatively.
Literatur
1.
Zurück zum Zitat Wolf MB, Haas A, Dragu A, Leclère FM, Dreyhaupt J, Hahn P, Unglaub F (2012) Arthroscopic repair of ulnar-sided triangular fibrocartilage complex (Palmer Type 1B) tears: a comparison between short- and midterm results. J Hand Surg [Am] 37:2325–2330. doi:10.1016/j.jhsa.2012.08.027 CrossRef Wolf MB, Haas A, Dragu A, Leclère FM, Dreyhaupt J, Hahn P, Unglaub F (2012) Arthroscopic repair of ulnar-sided triangular fibrocartilage complex (Palmer Type 1B) tears: a comparison between short- and midterm results. J Hand Surg [Am] 37:2325–2330. doi:10.​1016/​j.​jhsa.​2012.​08.​027 CrossRef
2.
5.
Zurück zum Zitat Corso SJ, Savoie FH, Geissler WB, Whipple TL, Jiminez W, Jenkins N (1997) Arthroscopic repair of peripheral avulsions of the triangular fibrocartilage complex of the wrist: a multicenter study. Arthroscopy 13:78–84PubMedCrossRef Corso SJ, Savoie FH, Geissler WB, Whipple TL, Jiminez W, Jenkins N (1997) Arthroscopic repair of peripheral avulsions of the triangular fibrocartilage complex of the wrist: a multicenter study. Arthroscopy 13:78–84PubMedCrossRef
9.
Zurück zum Zitat Palmer AK (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg [Am] 14:594–606, ReviewCrossRef Palmer AK (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg [Am] 14:594–606, ReviewCrossRef
10.
Zurück zum Zitat Cooney WP, Bussey R, Dobyns JH, Linscheid RL (1987) Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 214:136–147PubMed Cooney WP, Bussey R, Dobyns JH, Linscheid RL (1987) Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 214:136–147PubMed
12.
Zurück zum Zitat Germann G, Wind G, Harth A (1999) The DASH (disability of arm-shoulder-hand) questionnaire–a new instrument for evaluating upper extremity treatment outcome. Handchir Mikrochir Plast Chir 31:149–152, GermanPubMedCrossRef Germann G, Wind G, Harth A (1999) The DASH (disability of arm-shoulder-hand) questionnaire–a new instrument for evaluating upper extremity treatment outcome. Handchir Mikrochir Plast Chir 31:149–152, GermanPubMedCrossRef
13.
Zurück zum Zitat Hunsaker FG, Cioffi DA, Amadio PC, Wright JG, Caughlin B (2002) The American academy of orthopaedic surgeons outcomes instruments: normative values from the general population. J Bone Joint Surg Am 84:208–215PubMed Hunsaker FG, Cioffi DA, Amadio PC, Wright JG, Caughlin B (2002) The American academy of orthopaedic surgeons outcomes instruments: normative values from the general population. J Bone Joint Surg Am 84:208–215PubMed
15.
Zurück zum Zitat Zachee B, De Smet L, Fabry G (1993) Arthroscopic suturing of TFCC lesions. Arthroscopy 9:242–243PubMedCrossRef Zachee B, De Smet L, Fabry G (1993) Arthroscopic suturing of TFCC lesions. Arthroscopy 9:242–243PubMedCrossRef
16.
Zurück zum Zitat Thiru RG, Ferlic DC, Clayton ML, McClure DC (1986) Arterial anatomy of the triangular fibrocartilage of the wrist and its surgical significance. J Hand Surg [Am] 11:258–263CrossRef Thiru RG, Ferlic DC, Clayton ML, McClure DC (1986) Arterial anatomy of the triangular fibrocartilage of the wrist and its surgical significance. J Hand Surg [Am] 11:258–263CrossRef
19.
21.
Zurück zum Zitat Degreef I, Welters H, Milants P, Van Ransbeeck H, De Smet L (2005) Disability and function after arthroscopic repair of ulnar avulsions of the triangular fibrocartilage complex of the wrist. Acta Orthop Belg 71:289–293PubMed Degreef I, Welters H, Milants P, Van Ransbeeck H, De Smet L (2005) Disability and function after arthroscopic repair of ulnar avulsions of the triangular fibrocartilage complex of the wrist. Acta Orthop Belg 71:289–293PubMed
22.
23.
24.
25.
Zurück zum Zitat McAdams TR, Hentz VR (2002) Injury to the dorsal sensory branch of the ulnar nerve in the arthroscopic repair of ulnar-sided triangular fibrocartilage tears using an inside-out technique: a cadaver study. J Hand Surg [Am] 27:840–844CrossRef McAdams TR, Hentz VR (2002) Injury to the dorsal sensory branch of the ulnar nerve in the arthroscopic repair of ulnar-sided triangular fibrocartilage tears using an inside-out technique: a cadaver study. J Hand Surg [Am] 27:840–844CrossRef
Metadaten
Titel
Clinical experience with arthroscopically-assisted repair of peripheral triangular fibrocartilage complex tears in adolescents—technique and results
verfasst von
Sebastian Farr
Ulrike Zechmann
Rudolf Ganger
Werner Girsch
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 8/2015
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2795-6

Weitere Artikel der Ausgabe 8/2015

International Orthopaedics 8/2015 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.