Open repair and reconstruction of the TFCC

Since 1998, there were 212 wrist who underwent open repair of the TFCC for fovea avulsion injury. There were also 75 wrists who underwent reconstruction using half-slip of the extensor carpi ulnaris (ECU) tendon with a very small interference screw. We examine the clinical outcome of these procedures with a minimum of 1 year follow-up.

Methods: In open repair, detached TFCC is introduced to the fovea using double mattress repair technique. In reconstruction, the ECU half-slip induced inside the TFCC, was tightly sutured to the remnant TFCC, and pulled out through the bone tunnel that was made at the center of the fovea by 2.5 mm diameter drill. The ECU half-slip was subsequently anchored to the ulnar fovea with a bone peg and a small titanium interference screw.

There were 212 wrist of 209 patients who underwent open repair of the TFCC. There were 123 males and 86 females, right 113, l3ft 93 and 3 bilateral, with an average age of 28 (range 11-85). Average follow-up was 43 months (24-165). There were 75 wrists of 74 patients who underwent ECU half-slip tendon reconstruction, including 32 male, 42 female, 49 right, 24 left, 1 bilateral. Mean age was 38 years (range 13-68) and an average follow-up was 53 months (range, 12-156 months). In 15 wrists indicated the positive variance wrists, the ulnar shortening equalized the abutment before the reattachment. Clinical results were evaluated by DRUJ evaluating system.

Results: We obtained 160 excellent, 44 good, 5 fair and 3 poor results in open repair. There were 50 excellent, 18 good, 3 fair and 4 poor results in reconstruction.

Summary Points: Open repair and anatomical reattachment technique of the TFCC to the ulnar fovea using ECU half-slip tendon obtained excellent and good clinical results in most of the cases.