Should all superficial peripheral triangular fibrocartilage complex tears be arthroscopically repaired?

Abstract

Background Superficial peripheral triangular fibrocartilage complex (TFCC) tears are commonly encountered during diagnostic wrist arthroscopy done for other causes of wrist pain. The authors hypothesized that debridement of these tears in symptomatic post-traumatic superficial tears may be a sufficient alternative to arthroscopic repair. Patients and methods The authors conducted a prospective study including 29 patients with superficial peripheral TFCC tears (with no distal radioulnar joint instability) treated arthroscopically between 2011 and 2014. There were 26 males (89.7%) and three females (10.3%), with a mean age of 32.90 years (range: 21–59 years). The dominant hand was affected in 19 patients (65.5%) and the nondominant in 10 patients (34.5%). Patients were divided into two groups. The first group included 14 patients to whom arthroscopic shaving and debridement (debridement group) were done. The second group included 15 patients for whom arthroscopic repair (repair group) was done using the outside-in technique. Patients were evaluated with the visual analog scale (VAS) for pain, the quick score disability arm shoulder hand (DASH) score, and Mayo modified wrist score. Results There were no statistically significant differences in pain, disability, and functional scoring between both groups in the short-term follow-up. In the first group, the mean follow-up period was 21.87 months. The mean VAS improved from 3.53 to 1.07, the mean quick DASH score improved from 36.33 to 21.60, and the mean Mayo modified wrist score improved from 71.33 to 85.33. In the second group, the mean follow-up period was 19.71 months. The mean VAS improved from 3.86 to 1, the mean quick DASH score improved from 34.43 to 19.79, and the mean Mayo modified wrist score improved from 77.14 to 90. Conclusion Arthroscopic debridement gives comparable short-term results to repair in symptomatic superficial tear of the TFCC presenting with pain and no instability. Debridement group showed less complication and reoperation rate.