Open repair of the ulnar disruption of the triangular fibrocartilage complex with double three-dimensional mattress suturing technique

Techniques in Hand & Upper Extremity Surgery
Toshiyasu NakamuraShinichiro Takayama

Abstract

Open repair technique of the ulnar disruption of the triangular fibrocartilage complex is described. This technique is indicated for a fresh or a relatively fresh (less than 1 year after the initial injury) ulnar foveal detachment tear, horizontal tear, and proximal slit tear of the triangular fibrocartilage complex, all of which are accompanied by severe dorsal, palmar, or multidirectional instability of the distal radioulnar joint. A chronic tear greater than 1 year from initial injury and a fresh triangular fibrocartilage complex tear without distal radioulnar joint instability, such as central slit tear, are excluded from our indications. A dorsal C-shaped skin incision, a longitudinal incision of the radial edge of the extensor carpi ulnaris subsheath and the dorsal distal radioulnar joint capsule, exposes the distal radioulnar joint. A small, 5-mm longitudinal incision at the origin of the radioulnar ligament exposes its fovea detachment and/or the proximal slit tear of the triangular fibrocartilage complex. The disrupted radioulnar ligament is sutured in a pullout fashion to the ulna with a 3-dimensional double mattress technique through 2 bone tunnels that is precisely made at the central portion of the fovea with 1.2-m...Continue Reading

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Citations

Nov 9, 2014·Archives of Orthopaedic and Trauma Surgery·Christian K SpiesJohannes Oppermann
Jan 29, 2013·The Journal of Hand Surgery·Takaaki ShinoharaHitoshi Hirata
Aug 27, 2011·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Norimasa IwasakiAkio Minami
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Dec 10, 2016·The Journal of Hand Surgery, European Volume·T NakamuraK Sato
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Nov 16, 2018·The Journal of Hand Surgery Asian-Pacific Volume·Sandra PfannerMassimo Ceruso
Dec 9, 2008·Techniques in Hand & Upper Extremity Surgery·Andrea AtzeiTracy Fairplay
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Feb 10, 2021·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Gerhild ThalhammerHeinrich-Geert Tünnerhoff
Apr 6, 2021·Journal of Wrist Surgery·Toshiyasu NakamuraClayton A Peimer

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