The Effect of Open Surgery in Comparison with Supportive Treatment on Improvement of Traumatic Triangular Fibrocartilage Complex: A Clinical Trial Study

Document Type : Original Article (s)

Authors

1 Professor, Department of Orthopedic, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Orthopedic, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Resident, Department of Orthopedic, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Notice to importance of traumatic triangular fibrocartilage complex (TFCC), this study aimed to compare the effect of open surgery and supportive medical treatment on the improvement of trauma and quality of life in patients with TFCC.Methods: In a clinical trial study, 32 patients with triangular fibrocartilage trauma were selected and randomly divided into two groups of intervention and control. The intervention group underwent open surgery and the control group were receiving supportive treatments as non-steroidal anti-inflammatory drugs (NSAIDS), physiotherapy, and corrective action. All patients were followed for 3 months after intervention, and quality of life and improvement was evaluated using Mayo score, and compared between the two groups.Findings: The mean Mayo score before intervention was 30.0 ± 7.8 and 29.4 ± 10.7 in open surgery and supportive treatment groups, respectively, and no statistically difference was seen between the two groups (P = 0.560). The mean Mayo score after intervention was 68.2 ± 6.4 and 42.2±10.3 in surgery and supportive treatment groups, respectively, and the difference between groups was statistically significant (P < 0.001).Conclusion: Our study showed that open surgery in patients with TFCC is better than the conservative treatment.

Keywords

References

  1. Casadei K, Kiel J. Triangular fibrocartilage complex (TFCC) injuries. InStatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2020.
  2. Andersson JK, Axelsson P, Stromberg J, Karlsson J, Friden J. Patients with triangular fibrocartilage complex injuries and distal radioulnar joint instability have reduced rotational torque in the forearm. J Hand Surg Eur Vol 2016; 41(7): 732-8.
  3. Atzei A, Luchetti R, Garagnani L. Classification of ulnar triangular fibrocartilage complex tears. A treatment algorithm for Palmer type IB tears. J Hand Surg Eur Vol 2017; 42(4): 405-14.
  4. Xing SG, Xie RG, Tang JB. The correlation of fracture patterns of distal radius fractures and triangular fibrocartilage complex injures. Hand (New York, N,Y) 2016; 11(1_suppl): 40S.
  5. 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(7): 1086-106.
  6. Gutierrez AE, Montero JA, Gutierrez LE. Instability from the distal radioulnar joint: reconstruction and evolution of dorsal triangular fibrocartilage complex ligament. Acta Ortop Mex 2007; 21(5): 282-8.
  7. [In Spanish].
  8. Ahn AK, Chang D, Plate AM. Triangular fibrocartilage complex tears: a review. Bull NYU Hosp Jt Dis 2006; 64(3-4): 114-8.
  9. Abe Y, Moriya A, Tominaga Y, Yoshida K. Dorsal tear of triangular fibrocartilage complex: Clinical
  10. features and treatment. J Wrist Surg 2016; 5(1): 42-6.
  11. Aldrich K, Gellman H. Open triangular fibrocartilage complex repair. In: Anh Tran T, Panthaki ZJ, Hoballah JJ, Thaller SR, editors. Operative dictations in plastic and reconstructive surgery. Cham, Switzerland: Springer International Publishing; 2017. p. 391-2.
  12. Dlabach JA, Crockarell J. Campbell's operative orthopaedics. In: Campbell WC, Canale ST, Beaty JH, editors. Acute dislocations. Philadelphia, PA: Mosby/Elsevier; 2008. p. 3173-6.
  13. Atzei A, Luchetti R, Braidotti F. Arthroscopic foveal repair of the triangular fibrocartilage complex. J Wrist Surg 2015; 4(1): 22-30.
  14. Moritomo H. Open repair of the triangular fibrocartilage complex from palmar aspect. J Wrist Surg 2015; 4(1): 2-8.
  15. Andersson JK, Ahlen M, Andernord D. Open versus arthroscopic repair of the triangular fibrocartilage complex: A systematic review. J Exp Orthop 2018; 5(1): 6.
  16. Chou CH, Lee TS. Peripheral tears of triangular fibrocartilage complex: results of primary repair. Int Orthop 2001; 25(6): 392-5.
  17. Sander AL, Sommer K, Kaiser AK, Marzi I, Frank J. Outcome of conservative treatment for triangular fibrocartilage complex lesions with stable distal radioulnar joint. Eur J Trauma Emerg Surg 2020. [Epub ahead of print].
Journal of Isfahan Medical School
Volume 38, Issue 598 - Serial Number 598
September and October 2021
Pages 818-823

Files

History

  • Receive Date: 25 January 2020
  • Revise Date: 06 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics