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Surgical Technique for Repairing Foveal Tear of the Triangular Fibrocartilage Complex: Arthroscopic Knotless Repair.

Journal of the Korean Society for Surgery of the Hand.2014;19(2):103-108. doi:10.12790/jkssh.2014.19.2.103

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*

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Surgical Techniques for Repairing Foveal Tear of the Triangular Fibrocartilage Complex: Arthroscopic Transosseous Repair.

Jong Woong PARK

Journal of the Korean Society for Surgery of the Hand.2014;19(2):95-102. doi:10.12790/jkssh.2014.19.2.95

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*

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Open Repair of Triangular Fibrocartilage Complex Type 1B Tear.

In Hyeok RHYOU

Journal of the Korean Society for Surgery of the Hand.2014;19(2):87-94. doi:10.12790/jkssh.2014.19.2.87

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

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Chronic Instability of Distal Radioulnar Joint.

Hyun Dae SHIN ; Soo Min CHA

Journal of the Korean Society for Surgery of the Hand.2014;19(2):79-86. doi:10.12790/jkssh.2014.19.2.79

Chronic instability of distal radioulnar joint (DRUJ) can develop after injury such as fractures or dislocations, to the bony structures or to the soft tissue as like ligament, capsule. If proper treatment is not performed, normal biomechanics of DRUJ would be altered, thus arthritic joint with chronic functional impairment, pain resulted in. The proper treatments included several procedures for repair of the bony structures and recovery of realignment, various methods for soft tissue repair and reconstruction in unstable condition without bony structures destruction. Several salvage methods such as Darrach procedure, hemiresectional interposition arthroplasty, Sauve-Kapandji procedure, were recommended for the advanced arthritic DRUJ. Wide ulnar resection, one-bone forearm procedure, prosthetic replacement for DRUJ were rarely indicated, but the a few long-term results were reported. Operative stabilization (repair or reconstruction) for each structure assumed as DRUJ instability, is essential and proper selection among the several salvage procedures for the advanced arthritis joint, is needed.
Arthritis ; Arthroplasty ; Dislocations ; Forearm ; Joints* ; Ligaments

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Acute Dislocation of Distal Radioulnar Joint.

Soo Hong HAN ; Ho Jae LEE

Journal of the Korean Society for Surgery of the Hand.2014;19(2):70-78. doi:10.12790/jkssh.2014.19.2.70

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

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Acute Traumatic Irreducible Anterior Dislocation and Fracture of the Radial Head in an Adult.

Sang Wook BAE ; Yun Sun CHOI ; Hyong Suk KIM ; Baek Yong SONG

Journal of the Korean Society for Surgery of the Hand.2014;19(2):65-69. doi:10.12790/jkssh.2014.19.2.65

Traumatic dislocation of the radial head without fracture of the olecranon is very rare, especially in adults. We experienced a case of irreducible radial head dislocation with fracture without involvement of ulna. Open reduction and internal fixation was performed. During surgery, brachialis was interposed between capitellum and radial head, and also interposed between the fragments at the fracture site of the radial head. At 12 months after operation, the radial head was well reduced with normal rotation.
Adult* ; Dislocations* ; Head* ; Humans ; Olecranon Process ; Ulna

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Factors Affecting the Occurrence of Distal Radioulnar Joint Arthritis after Ulnar Shortening Osteotomy.

Chol Jin KIM ; Ho Jin GIL ; Yang Guk CHUNG ; Seung Han SHIN ; Dong Hyun KIM ; Jun Soo PARK ; Hyun Chul CHOI

Journal of the Korean Society for Surgery of the Hand.2014;19(2):57-64. doi:10.12790/jkssh.2014.19.2.57

PURPOSE: Ulnar shortening osteotmy is a common operation for the treatment of ulnar impaction syndrome. The purpose of this study was to evaluate factors that may affect the occurrence of distal radioulnar joint (DRUJ) arthritis after ulnar shortening osteotomy. METHODS: From September 2005 to August 2012, we performed 81 ulnar shortening osteotomies for ulnar impaction syndrome, and evaluated occurrence or deterioration of DRUJ arthritis in 58 patients with a minimum follow-up of 1 year. We analyzed potential factors that may affect the occurrence of DRUJ arthritis, such as, age, sex, hand dominance, pre- and postoperative ulnar variance, preexisting DRUJ arthritis, types of radial sigmoid notch, amount of ulnar shortening, and follow up period. RESULTS: DRUJ arthritis occurred or deteriorated in 32 out of the 58 patients. Regression analysis indicated a significant correlation between the type of radial sigmoid notch (type 1) and DRUJ arthritis. Other factors were not found to be correlated with occurrence or deterioration of DRUJ arthritis. CONCLUSION: This study suggests that patients with type 1 radial sigmoid notch (ulnar inclination of more than 10 degrees) are more likely to develop DRUJ arthritis after ulnar shortening osteotomy.
Arthritis* ; Colon, Sigmoid ; Follow-Up Studies ; Hand ; Humans ; Joints* ; Osteotomy*

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Sensory Neuropathy of the Common Palmar Digital Nerve Caused by Ganglion Cyst.

Jae Hoon LEE ; Young Joo CHO

Journal of the Korean Society for Surgery of the Hand.2015;20(1):39-42. doi:10.12790/jkssh.2015.20.1.39

Ganglion cysts that arise from the palm and compress the median nerve are rarely reported. Previous studies have described ganglion cysts compressing the motor branch of the median nerve, but no reports have described sensory neuropathy of the common palmar digital nerve as a result of ganglion cysts. We present a case of sensory neuropathy similar to carpal tunnel syndrome caused by a ganglion cyst that originated from the second carpometacarpal joint.
Carpal Tunnel Syndrome ; Carpometacarpal Joints ; Ganglion Cysts* ; Median Nerve

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Carpal Tunnel Syndrome and Rupture of Flexor Tendon Associated from Neglected Anterior Lunate Dislocation.

Young Yool CHUNG ; Young Jae JANG

Journal of the Korean Society for Surgery of the Hand.2015;20(1):33-38. doi:10.12790/jkssh.2015.20.1.33

Anterior dislocation of lunate is rare, it can result in median nerve compression and attritional rupture of flexor tendon when delay diagnosed. We report a patient with second finger flexor tendon rupture and carpal tunnel syndrome caused by neglected anterior lunate dislocation. Patient underwent operative treatment for that excised lunate, released carpal tunnel and reconstructed second flexor tendon using palmaris longus tendon. One year after surgery, fucntional and neurologic symptom were recovered. Also carpal alignment was maintained on plain radiographs, even after excision of the lunate.
Carpal Tunnel Syndrome* ; Dislocations* ; Fingers ; Humans ; Median Nerve ; Neurologic Manifestations ; Rupture* ; Tendons*

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Flexor Pollicis Longus Tendon Rupture due to Scaphoid Nonunion.

Jung Hyun PARK ; Hong Je KANG

Journal of the Korean Society for Surgery of the Hand.2015;20(1):28-32. doi:10.12790/jkssh.2015.20.1.28

Flexor pollicis longus rupture due to scaphoid nonunion is very rare complication. It has never been reported in the Korean literatures. We reported a case of flexor pollicis longus rupture due to scaphoid non union that was treated by tendon graft with palmaris longus and osteosynthesis with bone graft.
Rupture* ; Tendons* ; Transplants

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