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Management of Type 1D Tears

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Wrist and Elbow Arthroscopy

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Abstract

The triangular fibrocartilage complex is an essential structure for the transmission of forces through the wrist and for the stability of the distal radioulnar joint.

Two facts have been the basis of the classical treatment of its radial lesions consisting only of the debridement of the torn ligament. In the first place it was considered that, given that it showed a lesser vascularization, its healing was also lesser and. In second place, it was thought that its reinsertion did not influence in the mechanics of the distal radioulnar joint. By the same token, the fact that the classical reparative arthroscopic techniques are not simple, results in many authors have not habitually carried out a reinsertion of these lesions.

Nowadays it is known that not all the radial lesions of TFCC are the same. It is absolutely fundamental to evaluate whether the dorsal and volar portion of the triangular fibrocartilage, that is to say the radioulnar ligaments, are affected, since their tearing could entail a radioulnar instability. It is also known that these ligaments do have a healing capacity and thus we would advocate the repair of a radial tear if it were possible.

In this chapter a simple arthroscopic technique which will allow to repair a radial lesion of the TFCC back down to the bone without the necessity of making knots or bone tunnels that cross the radius will be explained.

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Authors and Affiliations

  1. Section of Hand Surgery, Orthopaedic and Trauma Department, Infanta Leonor University Hospital and Beata María Ana Hospital, C/ Gran Vía del Este Nº80, 28031, Madrid, Spain

    Fernando Corella Ph.D. & Montserrat Ocampos M.D.

  2. Hand Surgery Unit, Beata María Ana Hospital, C/ Doctor Esquerdo, 83, 28007, Madrid, Spain

    Miguel Del Cerro M.D.

Authors
  1. Fernando Corella Ph.D.
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  2. Miguel Del Cerro M.D.
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  3. Montserrat Ocampos M.D.
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Correspondence to Fernando Corella Ph.D. .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, University of Mississippi, Jackson, Mississippi, USA

    William B. Geissler

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Corella, F., Del Cerro, M., Ocampos, M. (2015). Management of Type 1D Tears. In: Geissler, W. (eds) Wrist and Elbow Arthroscopy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1596-1_7

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  • DOI: https://doi.org/10.1007/978-1-4614-1596-1_7

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