gms | German Medical Science

Objectives/Interrogation: Our primary objective is to describe TFCC injuries that required treatment in three different clinical scenarios. Additionally, to correlate the physical exam and MRI with the arthroscopic findings

Methods: Retrospective study including 105 patients and 107 wrists with TFCC injuries treated arthroscopically between January 2015 and July 2018.

We included patients with DRUJ instability (69), ulnar impaction syndrome (25) and patients with arthroscopic indication different from TFCC injury (13). Only were included patients who required treatment. Patients with distal radius fracture were excluded.

TFCC injuries were classified according to Palmer and Atzei classifications.

All physical examinations and MRI results were compared with the arthroscopic findings.

No functional results were evaluated.

Results and Conclusions: From a total of 107 wrists, 63% presented type 1B injuries, 14% type 2A, 9% type 1C, 7% type 1A and 3% type 2C according to Palmer.

In the type 1B injuries group, 72% presented type 3 injuries and 27% type 2 according to Atzei.

In the DRUJ instability group 83% presented type 1B injuries. In the ulnar impaction syndrome group 40% presented type 1B injuries and 32% type 2A. In the miscellaneous group the findings were heterogeneous without trends.

In the main group 88% presented a positive fovea sign and 72% a positive ballottement test.

The DRUJ instability group and the ulnar impaction syndrome group they both presented a positive fovea sign in all cases. 97% of the DRUJ instability group and 40% of the ulnar impaction syndrome presented a positive ballottement test.

In the miscellaneous grupo those findings were not seen.

Only in three cases the MRI was entirely coincident with the arthroscopic findings.

The DRUJ instability appeared to be highly suggestive of proximal tear of the TFCC.

In patients with ulnar impaction syndrome we need to consider the existence both proximal and degenerative injuries.

The fovea sing seems to be highly sensitive for TFCC injuries, and the ballottement test highly specific for proximal tears.

The MRI not prove to be a useful tool to diagnose or rule out clinically relevant injuries of the TFCC.