Arthroscopic Repair of Triangular Fibrocartilage Complex Tears

PURPOSE: The objective of this study was to investigate the clinical results and functional outcomes of patients with peripheral triangular fibrocartilage complex (TFCC) lesions repaired by arthroscopic technique and to describe the pathology of dorsal tears of the TFCC, which was not described in Palmer's classification. METHODS: Thirty-five patients with arthroscopic repair of TFCC tears were reviewed. There were 22 males and 13 females. The average age was 33 years (range, 13 to 51 years). The average follow-up was 39 months (range, 4 to 82 months). TFCC tears were classified by the Palmer classification as follows: IB (11), IC (5), and ID (1). The remaining 18 were not classified according to the Palmer classification. Functional results were evaluated using the ADL (activities of daily living) score and the Modified Mayo Wrist Score. RESULTS: A dorsal peripheral tear found in 18 wrists does not fulfill the Palmer classification of traumatic TFCC injuries. Seventy-four percent of patients had reduction in pain after surgery, with improvement in grip strength and daily activities (P < .05). The Modified Mayo Wrist score was excellent in 54%, good in 20%, fair in 12%, and poor in 14%. Nineteen of 28 working patients returned to their original work. Ulnar nerve dorsal branch neuritis occurred in 17%. A "second-look" arthroscopy was performed on 9 patients with healing shown in 7. Additional procedures were performed on 10 patients (29%) to improve functional outcome. CONCLUSIONS: Arthroscopic repair of peripheral TFCC tears can provide satisfactory results. Seventy-four percent of our patients achieved good to excellent results, had significant pain relief, had increased grip strength, and had an increased capacity to perform daily activities. The Palmer classification does not completely classify all peripheral TFCC tears. LEVEL OF EVIDENCE: Level IV, therapeutic case series.