Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Cartilage Repair
Abstract number: 24305
A NOVEL MODIFIED OUTSIDE-IN TECHNIQUE OF ARTHROSCOPIC REPAIR OF
TRIANGULAR FIBROCARTILAGE COMPLEX TEARS
Paraskumar MOHANLAL, Amit TOLAT
Medway Maritime Hospital, Medway (UNITED KINGDOM)
INTRODUCTION: Tears of the triangular fibrocartilage complex (TFCC) usually occur
as a result of trauma but can happen as a result of age related degeneration. Some
TFCC tears produce mild symptoms and resolve with conservative treatment.
However, surgery is indicated when non-operative intervention fails. We describe a
novel modified outside-in technique of arthroscopic repair of TFCC tears. PATIENT
AND TECHNIQUE: A 40-year-old patient presented with wrist pain following a fall.
MRI scan revealed a peripheral tear of the TFCC for which he underwent wrist
arthroscopy. During arthroscopy an ulnar peripheral TFCC tear (Palmer 1B) was
noted. The rest of the joint was normal. An 18G Touhy epidural needle was passed
via the 6U portal through the periphery of the stump of torn TFCC. It was interlaced
through the radially retracted margin. A 2-0 PDS suture was then threaded through
the needle and then grasped with a Halstead haemostat. The suture was then routed
through the 6U portal with a grasper and a knot tied with the leading thread over the
capsule-TFCC junction till the gap was closed with a secure knot. The arthroscopic
portals were closed and the wrist splinted for 2 weeks. At follow-up, the patient was
recovering well and making a good functional recovery with physiotherapy.
CONCLUSION: Our technique is a modified outside-in technique using an 18G
Touhy needle for repair of TFCC tears. It is simple, easy to use with readily available
instruments. There is no need for special repair kits.
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