Arthroscopic Capsular Repair of TFCC

Pain in the ulnar side of the wrist is annoying and limits the patient's hand and wrist functions from tasks of daily living to recreational activity. In patients present with tenderness of the fovea but no instability of the DRUJ, the arthroscopic findings as peripheral tear of the TFCC and injury of the ulnocarpal ligaments with synovitis are related to the point of the tenderness. We treat this type of injury using arthroscopic outside-in capsular repair of the TFCC with simple instruments as hypodermic needles and a wire loop or a suture loop. The results of treatment are good to excellent in terms of pain relief and return to function. The most common complication is injury to the dorsal sensory branch of the ulnar nerve, which is transient and spontaneous recovery. Patient selection is very important; we recommend arthroscopic capsular repair in patients with ulnar-sided wrist pain without DRUJ instability and non-responsive to 3 months of conservative treatment.