Early functional outcomes following open reconstruction of the triangular fibrocartilage complex.

Abstract

Introduction: The triangular fibrocartilage complex (TFCC) plays a pivotal role in wrist stability and function. TFCC injuries are a common cause of ulnar-sided wrist pain and distal radioulnar joint (DRUJ) instability, often requiring surgical intervention when conservative treatments fail. This study evaluates the outcomes of open surgical repair of TFCC injuries, with a focus on functional recovery between 6 and 18 months postoperatively.

Methods: A total of 17 patients (10 males, seven females; mean age: 39.9 years) underwent open surgical repair for TFCC injuries between February 2022 and December 2023. The procedure, performed via a dorsal approach, utilized long-absorbable sutures and, when indicated, supplemental stabilization with a Kirschner wire. Patients followed a postoperative protocol of 6 weeks of immobilization (3 weeks in a forced supination cast followed by 3 weeks in a neutral position), with rehabilitation initiated 7 weeks postoperatively. Functional outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, along with measurements of grip strength and range of motion.

Results: The mean DASH score was 14.69, with grip strength recovery averaging 92.38% compared to the contralateral hand. All patients returned to work within 10.2 weeks and resumed amateur sports after 12.3 weeks. No reoperations or complications were reported. The procedure yielded significant improvements in grip strength and range of motion.

Conclusion: Open surgical repair of TFCC injuries is an effective and safe procedure for patients unresponsive to conservative treatment. This technique provides favorable functional outcomes and can be performed reliably in most trauma surgery departments without the need for advanced equipment or specialized expertise.