Abstract
We describe the association of tears of the TFCC in the frontal plane with distal radio-ulnar joint instability and positive ulnar variance. We have named this condition “coronal tear syndrome” due to the pattern of the tear.
Each of the patients presented to us with ulnar pain and a feeling of instability that began after a traumatic event. All patients had an ulna plus variant on preoperative X-rays. During arthroscopic exploration, each patient found to have degenerative tears, with various grades of chondromalacia involving the ulnar head and lunate. Each patient had a tear of the triangular fibrocartilage in the coronal plane that extended to the fovea. One surgeon managed the condition by open ulnar shortening and arthroscopic debridement, while the other by an arthroscopic wafer procedure and repair of the TFC with an all-in suturing technique.
The ulnar pain resolved in all patients. No instability was present after repair. One patient had a second look arthroscopy which showed near complete healing of the tear of the disk.
In conclusion, the surgeon can successfully manage this entity by purely arthroscopic methods or combined arthroscopic and open procedures. Additionally, biomechanical studies presented here support both the existence of this condition and the beneficial effect of stitching the tear or shortening the ulna.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Atzei A (2009) New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability. J Hand Surg Eur 34:582–591
Cooney WP, Linscheid RL, Dobyns JH (1994) Triangular fibrocartilage tears. J Hand Surg Am 19(1):143–154. PubMed PMID: 8169359
del Piñal F (2010) Treatment of explosion-type distal radius fractures. In: del Piñal F, Mathoulin C, Luchetti C (eds) Arthroscopic management of distal radius fractures. Springer, Berlin
del Piñal F (2011) Dry arthroscopy and its applications. Hand Clin 27:335–345
del Piñal, Nakamura T (2010) Coronal tears of the TFCC. In: Presented at the 26th International Wrist Investigator’s workshop, Boston, 2010
del Piñal F, García-Bernal FJ, Pisani D, Regalado J, Ayala H, Studer A (2007) Dry arthroscopy of the wrist: surgical technique. J Hand Surg Am 32:119–123
del Piñal F, García-Bernal FJ, Cagigal L, Studer A, Regalado J, Thams C (2010) A technique for arthroscopic all-inside suturing in the wrist. J Hand Surg Eur 35:475–479
del Piñal F, Studer A, Thams C, Glasberg A (2011) An all-inside technique for arthroscopic suturing of the volar scapholunate ligament. J Hand Surg Am 36:2044–2046
Estrella EP, Hung LK, Ho PC, Tse WL (2007) Arthroscopic repair of triangular fibrocartilage complex tears. Arthroscopy 23:729–737
Ishii S, Palmer AK, Werner FW, Short WH, Fortino MD (1998) An anatomic study of the ligamentous structure of the triangular fibrocartilage complex. J Hand Surg Am 23:977–985
Nakamura T, Yabe Y, Horiuchi Y (1996) Functional anatomy of the triangular fibrocartilage complex. J Hand Surg Br 21:581–586
Nakamura T, Makita A (2000) The proximal ligamentous component of the triangular fibrocartilage complex. J Hand Surg 25(5):479–486
Palmer AK (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am 14:594–606
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
del Piñal, F., Nakamura, T. (2012). Coronal Tears of the TFCC. In: del Piñal, F. (eds) Arthroscopic Management of Ulnar Pain. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30544-3_16
Download citation
DOI: https://doi.org/10.1007/978-3-642-30544-3_16
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-30543-6
Online ISBN: 978-3-642-30544-3
eBook Packages: MedicineMedicine (R0)