Differentiated Approaches to Treat Lesions of the TFCC Based on new
                    arthroscopic Classification

Toshiyasu Nakamura; Takehilko Takagi

doi:10.1055/a-1872-0109

Handchirurgie · Mikrochirurgie · Plastische Chirurgie, Table of Contents

Handchir Mikrochir Plast Chir 2022; 54(05): 389-398
DOI: 10.1055/a-1872-0109

Original Article

Differentiated Approaches to Treat Lesions of the TFCC Based on new arthroscopic Classification

Differentialtherapie von TFCC-Läsionen basierend auf einer neuen arthroskopischen Klassifikation

Authors

Toshiyasu Nakamura

¹Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan

²Department of Orthopaedic Surgery, National Center for Child Health and Development, Setagaya-ku, Japan
Takehilko Takagi

²Department of Orthopaedic Surgery, National Center for Child Health and Development, Setagaya-ku, Japan

Abstract

In this article, pathology of the TFCC lesions, image diagnosis and arthroscopic examination were described. According to the radiocarpal arthroscopic findings, TFCC lesions are classified into intra-disc lesions (Class 1), radial lesion (Class 2), peripheral disc lesions which indicate slight to moderate DRUJ instability (Class 3) and degenerative lesion (Class 4). The radioulnar ligament (RUL) lesions that indicate moderate to severe DRUJ instability were classified with staging system with DRUJ arthroscopic findings (Stage 1 to 5). Author’s treatment algorism with wrist arthroscopic findings including DRUJ arthroscopy was demonstrated and along with this algorism, various arthroscopic and open techniques to treat TFCC injuries were selected and resulted in success. Precise diagnosis of the TFCC lesions helped to select an adequate treatment for each lesion.

Zusammenfassung

Dieser Artikel beschreibt die pathologischen Veränderungen des TFCC sowie deren Befunde in der Bildgebung und Arthroskopie. Am TFCC lassen sich mittels Arthroskopie bei Sicht von radiokarpal zentrale (Typ 1), radiale (Typ 2) sowie periphere Läsionen (Typ 3), die mit einer moderaten Instabilität des distalen Radioulnargelenkes (DRUG) einhergehen, und degenerative Läsionen (Typ 4) unterscheiden. Läsionen der radioulnaren Bänder, die mit einer moderaten bis ausgeprägten Instabilität des DRUG vergesellschaftet sind, werden anhand der Befunde bei der DRUG-Arthroskopie in fünf Stadien eingeteilt. Diesen unterschiedlichen Befunden angepasst wurde ein Behandlungsalgorithmus mit verschiedenen arthroskopischen und offenen Verfahren entwickelt, der sich als erfolgreich erwies. Eine exakte Klassifizierung von TFCC-Läsionen ermöglicht die Wahl des für die jeweilige Läsion adäquaten Therapieverfahrens.

Key words

Triangular fibrocartilage complex - arthroscopic exploration - arthroscopic repair - open repair - reconstruction

Schlüsselwörter

Triangulärer fibrokartilaginärer Faserknorpel - arthroskopische Untersuchung - arthroskopische Behandlung - offene Behandlung - Rekonstruktion

Full Text

References

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