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J Wrist Surg 2024; 13(01): 058-065
DOI: 10.1055/s-0042-1751017
Procedure

All-Arthroscopic Foveal Triangular Fibrocartilage Complex Tendon Reconstruction

Camelia Q. Y. Tang 
1   Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore
,
Jackson K. H. Jiang
1   Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore
2   Department of Orthopaedic Surgery, Sengkang General Hospital, Singapore
3   Singhealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme, Singapore
,
Andrew Y. H. Chin
1   Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore
3   Singhealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme, Singapore
,
Muntasir M. Choudhury
1   Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore
2   Department of Orthopaedic Surgery, Sengkang General Hospital, Singapore
3   Singhealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme, Singapore
› Author Affiliations Funding None.
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Abstract

Background In symptomatic chronic injury of ulnar-sided tear of the triangular fibrocartilage complex, reconstruction techniques involving foveal reconstruction with palmaris longus tendon graft using the method described by Bain have been described with good outcomes.

Description of Technique With increasing popularity of wrist arthroscopy to address various wrist pathologies, we present our technique of arthroscopic foveal reconstruction. We also include a step-by-step description of the procedure with illustrations, with aims to aid surgeons in executing it

Conclusion Unlike other arthroscopic techniques described, this involves single osseous ulnar tunnel and performed completely arthroscopically, allowing an end result similar to Bain's open technique.

Keywords

wrist arthroscopy - triangular fibrocartilage complex - foveal reconstruction - DRUJ instability - distal radioulnar joint

Note

This work was performed in Sengkang General Hospital, Singapore.




Publication History

Received: 08 February 2022

Accepted: 17 May 2022

Article published online:
06 July 2022

© 2022. Thieme. All rights reserved.

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  • References

  • 1 Palmer AK. Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am 1989; 14 (04) 594-606
    CrossrefPubMedSearch in Google Scholar
  • 2 Atzei A. New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability. J Hand Surg Eur Vol 2009; 34 (05) 582-591
    CrossrefPubMedSearch in Google Scholar
  • 3 Atzei A, Luchetti R, Garagnani L. Classification of ulnar triangular fibrocartilage complex tears. A treatment algorithm for Palmer type IB tears. J Hand Surg Eur Vol 2017; 42 (04) 405-414
    CrossrefPubMedSearch in Google Scholar
  • 4 Adams BD, Berger RA. An anatomic reconstruction of the distal radioulnar ligaments for posttraumatic distal radioulnar joint instability. J Hand Surg Am 2002; 27 (02) 243-251
    CrossrefPubMedSearch in Google Scholar
  • 5 Teoh LC, Yam AK. Anatomic reconstruction of the distal radioulnar ligaments: long-term results. J Hand Surg [Br] 2005; 30 (02) 185-193
    CrossrefPubMedSearch in Google Scholar
  • 6 Tse WL, Lau SW, Wong WY. et al. Arthroscopic reconstruction of triangular fibrocartilage complex (TFCC) with tendon graft for chronic DRUJ instability. Injury 2013; 44 (03) 386-390
    CrossrefPubMedSearch in Google Scholar
  • 7 Chu-Kay Mak M, Ho PC. Arthroscopic-assisted triangular fibrocartilage complex reconstruction. Hand Clin 2017; 33 (04) 625-637
    CrossrefPubMedSearch in Google Scholar
  • 8 Atzei A, Tandioy-Delgado FA, Marcovici LL, Aust TW, Luchetti R. Allinside Anatomic Arthroscopic (3A) Reconstruction of Irreparable TFCC Tear. J Wrist Surg 2021
    PubMed
  • 9 Bain GI, McGuire D, Lee YC, Eng K, Zumstein M. Anatomic foveal reconstruction of the triangular fibrocartilage complex with a tendon graft. Tech Hand Up Extrem Surg 2014; 18 (02) 92-97
    CrossrefPubMedSearch in Google Scholar
  • 10 Liu B, Fok MWM. The medium term outcomes of an all-arthroscopic triangular fibrocartilage complex foveal reconstruction using tendon graft. Int Orthop 2021; 45 (05) 1273-1279
    CrossrefPubMedSearch in Google Scholar
  • 11 Luchetti R, Atzei A. Arthroscopic assisted tendon reconstruction for triangular fibrocartilage complex irreparable tears. J Hand Surg Eur Vol 2017; 42 (04) 346-351
    CrossrefPubMedSearch in Google Scholar
  • 12 Nakamura T, Abe K, Nishiwaki M, Iwamoto T, Sato K. Medium- to long-term outcomes of anatomical reconstruction of the radioulnar ligament to the ulnar fovea. J Hand Surg Eur Vol 2017; 42 (04) 352-356
    CrossrefPubMedSearch in Google Scholar
  • 13 Nakamura T, Sato K, Okazaki M, Toyama Y, Ikegami H. Repair of foveal detachment of the triangular fibrocartilage complex: open and arthroscopic transosseous techniques. Hand Clin 2011; 27 (03) 281-290
    CrossrefPubMedSearch in Google Scholar