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J Hand Surg Eur Vol. 2014 Oct;39(8):845-55. doi: 10.1177/1753193413501977. Epub 2013 Aug 20.

Comparison between open and arthroscopic-assisted foveal triangular fibrocartilage complex repair for post-traumatic distal radio-ulnar joint instability.

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  • 1Rimini Hand and Rehabilitation Center, Rimini, Italy
  • 2Fenice Hand Surgery and Rehabilitation Team, Treviso, Pordenone, Italy.
  • 3Rimini Hand and Rehabilitation Center, Rimini, Italy.
  • 4Studio Fairplay, Hand Rehabilitation Private Center, Bologna, Italy.
  • 5Department of Hand Surgery and Surgery of Peripheral Nerves, University Hospital Bern, Bern, Switzerland.


The aim of this study was to assess the objective and subjective functional outcomes after foveal reattachment of proximal or complete ulnar-sided triangular fibrocartilage complex lesions by two surgical procedures: an open technique or an arthroscopically assisted repair. The study was done prospectively on 49 wrists affected by post-traumatic distal radio-ulnar joint instability. Twenty-four patients were treated with the open technique (Group 1) and 25 by the arthroscopically assisted technique (Group 2). Magnetic resonance imaging demonstrated a clear foveal detachment of the triangular fibrocartilage complex in 67% of the cases. Arthroscopy showed a positive ulnar-sided detachment of the triangular fibrocartilage complex (positive hook test) in all cases. Distal radio-ulnar joint stability was obtained in all but five patients at a mean follow-up of 6 months. Both groups had improvement of all parameters with significant differences in wrist pain scores, Mayo wrist score, Disability of the Arm, Shoulder and Hand questionnaire and Patient-Rated Wrist/Hand Evaluation questionnaire scores. There were no significant post-operative differences between the two groups in the outcome parameters except for the Disability of the Arm Shoulder and Hand questionnaire score, which was significantly better in Group 2 (p < 0.001).

© The Author(s) 2013.


Flexor carpi radialis tendonitis; basal joint arthritis; pseudotendon; suspensionplasty; tendon rupture; tenotomy

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