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Arthroscopic Repair of Palmer 1-B Tears of the Triangular Fibrocartilage Complex
ABSTRACT
Traumatic lesions of the triangular fibrocartilage complex of the wrist without frank instability of the distal radioulnar joint often present late with persistent ulnar-sided wrist pain. Avulsion tears from the base of the ulnar styloid, Palmer type 1-B are amenable to arthroscopic repair due to their peripheral location. This presentation discusses the arthroscopic findings, demonstrates the operative technique, and reviews arthroscopic repair results.
In this series of 18 patients, the diagnosis of triangular fibrocartilage complex tear was made clinically. No patient had noticeable subluxation of the distal radioulnar joint, but the joint was unstable on stress testing and all failed a trial of conservative treatment.
The operative technique will be demonstrated by video. The forearm was immobilized for 6 weeks postoperatively in a custom-fit brace that allowed wrist movement after 3 weeks.
Follow-up (range: 6-24 months) was available for 14 patients. One tear recurred 11 months postoperatively while lifting weights and 1 patient required symptomatic suture removal. The results of this study suggest arthroscopic surgery is a safe and effective way to treat Palmer type 1-B tears of the triangular fibrocartilage complex in patients without obvious instability of the distal radioulnar joint.