To the Editor
It was with great interest that we read the article by Dy et al. entitled, Peripheral Triangular Fibrocartilage Complex Tears Cause H Instability: A Biomechanical Pilot Study [1]. We congratulate the authors on this important study and its outcome; however, we have several questions. First, what method was used to transect the ligaments? Second, how was complete transection of the ligaments ensured [2, 3]? Finally, was an additional arthroscopy of the distal radioulnar joint [4] performed to confirm complete transection?
We believe these are important questions that need to be answered. Additionally, we would have liked to see arthroscopic images of the triangular fibrocartilage complex tear before and after transection of its attachment.
References
Dy CJ, Ouellette EA, Makowski AL, Milne E, Latta LL. Peripheral triangular fibrocartilage complex tears cause ulnocarpal instability: a biomechanical pilot study. Clin Orthop Relat Res. 2012. doi:10.1007/s11999-012-2399-z.
Ehman EC, Hayes ML, Berger RA, Felmlee JP, Amrami KK. Subluxation of the distal radioulnar joint as a predictor of foveal triangular fibrocartilage complex tears. J Hand Surg Am. 2011;36:1780–1784.
Kleinman WB. Stability of the distal radioulna joint: biomechanics, pathophysiology, physical diagnosis, and restoration of function. What we have learned in 25 years. J Hand Surg Am. 2007;32:1086–1106.
Slutsky DJ. Arthroscopic evaluation of the foveal attachment of the triangular fibrocartilage. Hand Clin. 2011;27:255–261.
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(Re: Dy CJ, Ouellette EA, Makowski AL, Milne E, Latta LL. Peripheral triangular fibrocartilage complex tears cause ulnocarpal instability: a biomechanical pilot study. Clin Orthop Relat Res. 2012 May 30. [Epub ahead of print])
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Unglaub, F., Leclere, F.M., Hahn, P. et al. Letter to the Editor: Peripheral Triangular Fibrocartilage Complex Tears Cause Ulnocarpal Instability: A Biomechanical Pilot Study. Clin Orthop Relat Res 470, 3265 (2012). https://doi.org/10.1007/s11999-012-2586-y
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DOI: https://doi.org/10.1007/s11999-012-2586-y