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KMID : 0621520140190040159
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Journal of the Korean Society for Surgery of the Hand
2014 Volume.19 No. 4 p.159 ~ p.166
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Clinical Outcomes of Open Surgical Repair for Triangular Fibrocartilage Complex Foveal Detachment
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Lim Kyung-Sup
Rhyou In-Hyeok
Kim Kyung-Chul
Lee Ji-Ho
Ahn Kee-Baek
Moon Sung-Chul
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Abstract
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Purpose: To investigate short term clinical outcomes of the open surgical repair for triangular fibrocartilage complex (TFCC) foveal detachment.
Methods: We retrospectively reviewed 8 patients (5 men, 3 women) who had been treated with open surgical repair of the TFCC type 1B injury, from 2005 to 2013 and who were followed up for more than one year after surgery. Mean age at time of surgery was 34 years. The right side was involved in 3 patients, and the left in 5. The clinical results of surgery were assessed with modified Mayo wrist score (MMWS), disabilities of the arm, shoulder and hand (DASH) score and pain-visual analogue scale (VAS). Physical examination was performed to evaluate the prescence of distal radioulnar instability, preoperatively and at the latest follow-up.
Results: The mean follow up period were 36.5 months (range, 12-64 months). The mean MMWS improved from 52.5 (range, 25-85) preoperatively to 82.5 (range, 75-100) postoperatively (p=0.02). The mean DASH score improved from 39.6 (range, 65-13.5) preoperatively to 13.4 (range, 2.5-33.3) postoperatively (p=0.012). The preoperative mean pain-VAS was 4.6 (range, 6-3); these value was reduced to mean 2 (range, 0-3) at the latest follow-up (p=0.016). There were no patients remaining instability after the surgery, although four patients showed distal radioulnar joint (DRUJ) instability before surgery.
Conclusion: The surgical outcomes of open repair for TFCC foveal detachment (type 1B) was contentable. Also, in cases of type 1B injury associated with DRUJ instability were managed sucessfully without additional procedure.
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KEYWORD
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Triangular fibrocartilage complex type 1B tear, Chronic disability of arm-shoulder-hand instability, Open fovea repair
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