A Study on TFCC Status after the Healing of Distal Radius Fracture with Plate Fixation

• Main Authors: Fok, Margaret Woon Man, Fang, Christian Xinshuo, Lau, Tak Wing, Fung, Boris Kwok Keung, Leung, Frankie Ka Li
• Format: Conference Proceeding
• Language: English
• ISSN: 2163-3916; 2163-3924
• DOI: 10.1055/s-0035-1567918

Introduction:  Acute distal radius fractures were associated with a high incidence of triangular fibrocartilage complex (TFCC) tear, with a percentage of up to 84%. The current postulation was that well-vascularized peripheral TFCC tears will heal, after anatomical reduction and fixation of distal radius fractures, without concomitant repair or postoperative immobilization. This study aims to evaluate the status of the TFCC after the healing of distal radius fractures with plate fixation. Method:  Patients who were elected for the removal of implants after union of distal radius fractures were recruited from August 2013 to June 2015. Concomitant wrist arthroscopy was performed to assess the status of the TFCC. Results:  42 patients, with 43 distal radius fractures, were studied. The average period from injury to the wrist arthroscopy was 12 months. There were 16 extra-articular distal radius fractures. Fifteen patients had ulnar wrist pain, and 28 were noted to have DRUJ instability on examinations. The findings of wrist arthroscopies revealed 25 complete and 10 incomplete (with signs of healing) TFCC tears. All patients with both symptoms and signs had TFCC tears, while the 8 patients with intact TFCC tear had neither symptoms nor signs. Sixty percent of the TFCC tears arose from the sigmoid notch, and 26% were fovea tears. Twenty percent of TFCC tears were combined tears. There were no correlation between ulnar wrist pain and the location of the TFCC tears. No complication was noted. Discussion:  This study reaffirms that distal radius fractures are associated with a high incidence of TFCC tear. A large majority of TFCC tears remain unhealed after the union of distal radius fractures. However, not all TFCC tears give rise to signs and symptoms.