Knotless repair of triangular fibrocartilage complex has several advantages. All procedures for triangular fibrocartilage complex repair could be done under arthroscopy in this technique. In addition, this technique allows for repair of deep layers of triangular fibrocartilage complex down to fovea of the ulnar head. This article describes arthroscopic repair of the Palmer type 1B triangular fibrocartilage complex tear using arthroscopic knotless technique.
Arthroscopy ; Head ; Triangular Fibrocartilage*

As the importance of the foveal attachment of the triangular fibrocartilage complex (TFCC) on the stability of the distal radioulnar joint (DRUJ) is emphasized, the traditional repair techniques such as arthroscopic capsular repair for the 1B TFCC tear become accepted as ineffective method for treating DRUJ instability. Recently, several techniques which repair the TFCC directly to the ulnar fovea have been developed and introduced. Further advances of the techniques will be expected with increasing knowledge of the anatomy and biomechanics of the TFCC and DRUJ. Regardless of the techniques, fundamental principle of anatomical repair of the TFCC to the ulnar fovea is utmost important. Herein we present our technique of arthroscopic transosseous repair by making a drill hole in the ulnar and securing the sutures with Pushlock anchors.
Joints ; Sutures ; Triangular Fibrocartilage*

Most common traumatic type 1B tear of triangular fibrocartilage complex (TFCC), according to the Palmer's classification, may lead to the loss of the stability of distal radioulnar joint and is known to be one cause of the persisted ular side wrist pain. Recently as the knowledge of the anatomical structures of the TFCC accumulates and the deep fiber of the distal radioulnar ligament is recognized to play a central role, an attempt to repair it to the original ulnar fovea insertion site has been done and reported successful results. Since the introduction of open technique, numerous arthroscopic technique has been developing. Here careful considerations ought to be given during open repair will be taken with review of the related articles.
Classification ; Joints ; Ligaments ; Triangular Fibrocartilage* ; Wrist

Arthroscopy became a popular techique for the diagnosis and treatment of wrist disorder. But the specific indications for the wrist arthroscopy are not well defined. So we reviewed our experience of 16 wrist arthroscopies of radiocarpal and midcarpal joints. With this review, arthroscopy was of benifit in the diagnosis and treatment of the lesion of the triangular fibrocartilage complex and also in the synovectomy.
Arthroscopy ; Diagnosis ; Humans ; Joints ; Triangular Fibrocartilage ; Wrist

The Palmer class 1B triangular fibrocartilage complex injury has two entities: a lesion with stable distal radioulnar joint and a lesion with distal radioulnar joint instability. Arthroscopic debridement of fibrocartilage disk is used in Palmer class 1A lesion. The surgeon should remove the portion of the fibrocartilage tissue until a mechanically stable and smooth residual rim remains. Arthroscopic repair is used in Palmer class 1B or 1D lesion using meniscal repair sutures. Ulnar detachment that can produce distal radioulnar ligament instability can also be repaired using bone anchor or pull out suture. Old age as well as positive ulnar variance is poor prognostic factors.
Arthroscopy ; Debridement ; Fibrocartilage ; Joint Instability ; Joints ; Ligaments ; Suture Anchors ; Sutures ; Triangular Fibrocartilage

Ganglions are the most common mass occurred in the wrist and hand. Ganglion usually arises from the dorsal aspect of the radiocarpal joint that may lead to the wrist pain. We report a patient with a ganglion of the triangular fibrocartilage complex. Using arthroscopic technique, ganglion located in triangular fibrocartilage complex was successfully excised.
Arthroscopes ; Ganglion Cysts ; Hand ; Humans ; Joints ; Triangular Fibrocartilage ; Wrist

PURPOSE: We studied the short term results of the arthroscopic repair of 1B type triangular fibrocartilage complex (TFCC) tear using a knotless suture anchor. METHODS: We evaluated 23 patients who underwent all-inside arthroscopic TFCC repair using a knotless suture anchor. The average follow-up duration was 6.6 months (range, 3-10 months). Mean duration of symptom was 10.9 months (range, 1 week-7 years). The arthroscopic finding documented 15 type 1B, 2 1B with 1D, and 6 1B with 2C lesions. All showed the positive hook test. The concomitant pathologies were 16 scapholunate injuries and 10 lunotriquetral injuries. TFCC tears were repaired by the knotless suture anchor. The Wafer procedure was done for 2C lesions. RESULTS: According to Mayo modified wrist score, the result was excellent in 4, good in 14 and fair in 5. Nineteen patients (82.6%) could return to his job or hobby. CONCLUSION: The all-inside arthroscopic repair using knotless suture anchor for TFCC 1B tear can provide good results. The appropriate management should be done for the concomitant pathologies for the better results.
Follow-Up Studies ; Humans ; Suture Anchors ; Sutures ; Triangular Fibrocartilage ; Wrist

Traumatic injuries of the distal radioulnar joint (DRUJ) is important problem that requires special consideration for treatment to prevent disability arising from failure to the diagnosis, treatment, and rehabilitation. Stability of the DRUJ is provided by a combination of bony and soft tissue architecture. The bony architecture of the DRUJ account for only 20% of the DRUJ stability and soft tissues including triangular fibrocartilage complex (TFCC), pronator quadratus, and interosseous membrane give major role on the stability. TFCC is generally accepted as the most essential soft tissue stabilizer of the DRUJ. Acute dislocation of DRUJ injury is commonly associated with forearm fractures but it occurs as an isolated injury even though it is relatively rare. DRUJ injury is the one of main source of chronic wrist pain, instability and the focus of this article is on acute dislocation injury of DRUJ and their management.
Diagnosis ; Dislocations* ; Forearm ; Joints* ; Membranes ; Rehabilitation ; Triangular Fibrocartilage ; Wrist

The purpose of this study was to identify the structural characteristics of the palmar carpal ligaments. The palmar carpal ligaments of the thirty-two wrist of Korean adults were dissected and observed with the surgical microscope and then measured the size of the ligaments. Palmar radiocarpal ligaments were composed of the five ligaments. The radiotriquetral ligament was appeared at 43.8%. The attaching types of radiocapitate ligament to radius were classified to three types. The first type is that the radiocapitate ligament is attached to radius not overlapped with medially situated ligaments, the second type is overlapped with medially situated ligaments partially, and third type is overlapped completely. The radiotriquetral ligamnet was attached to triquetrum with three types. The first type is superficially situated to ulnotriquetral ligament, the second type is deeply situated and third type is intermingled with ulnotriquetral ligament. The radiolunate ligament was the thickest than other ligaments. The palmar ulnocarpal ligaments were composed of the five ligaments. The ulnocapitate ligament was appeared at 59.4%. The ulnocapitate ligament was strong ligament in the length, the thickness, and the width. The palmar ulnocarpal ligaments were thin in compare with the palmar radiocarpal ligaments. Ulnoradiate and ulnopisiform ligament were not prominent, but these two ligaments were important in triangular fibrocartilage complex that was contributed stability to distal radioulnar joint. The distance from styloid process of radius to palmar radiocarpal ligaments was short in radiocapitate ligament, and long in radioscapholunate ligament.
Adult* ; Humans ; Joints ; Ligaments* ; Radius ; Triangular Fibrocartilage ; Wrist

PURPOSE: To analyze the findings of midcarpal and radiocarpal arthroscopic examinations in the diagnosis of wrist trauma and pathology focusing on interosseous ligament laxity. MATERIALS AND METHODS: Forty-one midcarpal arthroscopic examinations were performed in conjunction with radiocarpal arthroscopic examinations. Thirty-one wrists with distal radius fracture and ten wrists with triangular fibrocartilage complex tear were included. Scapholunate and lunotriquetral ligament laxity was graded by using the Geissler classification and radiocarpal and midcarpal arthroscopic findings were compared. RESULTS: For scapholunate findings midcarpal arthroscopy confirmed radiocarpal findings in 14 cases and provided a diagnosis in 6 cases. For lunotriquetral findings midcarpal arthroscopy confirmed radiocarpal findings in 13 cases and provided a diagnosis in 6 cases. CONCLUSIONS: Midcarpal arthroscopy added more statistically significant information to the results of radiocarpal examination than wrist arthroscopy performed without a midcarpal examination.
Arthroscopy* ; Classification ; Diagnosis ; Ligaments* ; Pathology ; Radius Fractures ; Triangular Fibrocartilage ; Wrist*