Arthroscopic repair of ulnar tear of triangular fibrocartilage complex by loop stitch using a suture anchor
10.3760/cma.j.cn501098-20230416-00211
- VernacularTitle:关节镜下带线锚钉套圈缝合法修复三角纤维软骨复合体尺侧撕裂
- Author:
Bin ZHU
1
;
Xiaoming CAI
;
Junjie LI
;
Yi CHEN
;
Jian ZHANG
;
Feng ZHU
;
Xin WANG
Author Information
1. 宁波市第六医院手外科，宁波 315000
- Keywords:
Carpal joints;
Arthroscopy;
Ligaments, articular;
Suture anchors
- From:
Chinese Journal of Trauma
2023;39(9):823-829
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of arthroscopic repair of ulnar tear of triangular fibrocartilage complex (TFCC) by loop stitch using a suture anchor.Methods:A retrospective case series study was used to analyze the clinical data of 46 patients with TFCC ulnar tear admitted to Ningbo Sixth Hospital from February 2019 to October 2020, including 28 males and 18 females; aged 18-64 years [(35.9±10.3)years]. All the patients had unilateral tears, including 18 on the left side and 28 on the right side, and all of them had Palmer type IB injuries. During the operation, one anchor was placed in the proximal end of the ulnar styloid process, and the ulnar side tear of the TFCC was repaired using arthroscopic anchor loop suture method. The visual analogue score (VAS), modified Mayo wrist score, disability of the arm, shoulder and hand (DASH) score, hand grip strength, wrist flexion and extension, and forearm rotation range of motion were compared before operation, at 3 months after operation, and at the last follow-up. The healing of surgical incisions and postoperative complications were observed.Results:All the patients were followed up for 13-35 months [24.0(17.5, 28.0)months]. The VAS, modified Mayo wrist score, DASH score and hand grip strength were improved from preoperative (4.2±0.9)points, (72.9±8.1)points, (27.9±4.7)points and (17.4±3.6)kg to (2.6±1.7)points, (82.1±6.1)points, (15.3±4.2)points and (20.3±3.5)kg at postoperative 3 months, and to (0.7±0.3)points, (91.8±4.2)points, (12.3±3.8)minutes and (23.6±4.1)kg at the last follow-up ( P<0.05 or 0.01), which were further improved at the last follow-up when compared to those at postoperative 3 months (all P<0.05). Based on the modified Mayo wrist score, the results were excellent in 28 patients, good in 14, and fair in 4 at the last follow-up, with an excellent and good rate of 91.3% (42/46). No significant differences were found in the wrist flexion-extension or forearm rotation range of motion before operation, at 3 months after operation, or at the last follow-up (all P>0.05). All surgical incisions achieved phase I healing. The postoperative complications included hypoesthesia and numbness of the skin on the ulnar side of the hand dorsum and the dorsal proximal section of the little finger in 3 patients and tenderness at the anchor in 2. No anchor loosening or prolapse occurred at the last follow-up. Conclusion:Arthroscopic repair of TFCC ulnar tear by loop stitch using a suture anchor can effectively relieve ulnar-sided wrist pain, improve the function of the wrist joint and upper limbs, and increase the grip strength of the hand, with fewer postoperative complications, making it an effective treatment method for TFCC ulnar tear.
