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A preliminary study on the effect of ligament stump retention technique on deep repair of triangular fibrocartilage complex

To investigate the impact of ligament stump retention on the clinical outcomes of deep repair of the triangular fibrocartilage complex (TFCC).

A retrospective study was conducted on 35 patients with moderate or severe radioulnar joint instability who had sustained an injury for 6-12 months. The patients were treated at the Affiliated Hospital of Qingdao University from January 2022 to February 2023. They were divided into two groups based on the surgical method: the non-residual TFCC repair group and the residual TFCC repair group. Variables such as gender, age, side of injury, TFCC classification, time of onset, operation time, length of stay, wrist flexion and extension range, forearm rotational range of motion, grip strength, VAS score, modified Mayo wrist score, and DRUJ score were analyzed. MRI imaging was used to evaluate the healing of the TFCC.

A total of 19 cases in the non-residual TFCC repair group and 16 cases in the residual TFCC repair group were included for comparison. Postoperative wrist rotation angle (140.84±4.60° vs 146.12±4.60°), median wrist flexion and extension angle (137° vs 142.5°), average modified Mayo score (84.21±5.84 vs 87.50±5.77), and median DRUJ score (9 vs 11) showed statistically significant differences (P < 0.05). However, there was no significant difference in grip strength and VAS score between the two surgical methods (P > 0.05). MRI grading indicated that the healing of the TFCC in the residual TFCC repair group was better than that in the non-residual TFCC repair group, with a statistically significant difference (P < 0.05).

The overall clinical efficacy and prognosis of TFCC deep injury repair with ligament stump retention are superior to those without ligament stump retention. Patients with ligament stump retention showed better stability of the distal radioulnar joint and were more satisfied with the surgery. For patients with deep TFCC injury, the TFCC deep anchor repair technique with ligament stump retention can be considered.

Suture anchors,arthroscopy, triangular fibrocartilage complex