Surgical Options for Triangular Fibrocartilage Complex Tears
Surgical Options for Triangular Fibrocartilage Complex Tears
Tears are categorized to help in treatment planning. Tears are divided into traumatic (Type 1) or degenerative (Type 2) according to the Palmer classification system. Type 1A (central) tears are generally not destabilizing to the DRUJ, while Type 1B (peripheral), 1C (ulnar) and 1D (radial) lesions may destabilize the DRUJ and thus warrant thorough evaluation for instability.
Atzei et al. proposed a treatment-oriented classification for peripheral tears based on DRUJ instability, status of the superficial and foveal attachments of the TFCC, healing potential and DRUJ chondromalacia. Class 1 are superficial tears with minimal DRUJ instability and are treated with a capsular based TFCC repair. Class 2 and 3 have greater DRUJ instability which involves the foveal TFCC attachments, and foveal TFCC repair is the recommended treatment. Class 4 tears have severe DRUJ instability and poor healing potential and are treated with tendon graft reconstruction, while Class 5 tears include any with severe DRUJ arthritis, necessitating a salvage operation.
Classification of TFCC Tears
Tears are categorized to help in treatment planning. Tears are divided into traumatic (Type 1) or degenerative (Type 2) according to the Palmer classification system. Type 1A (central) tears are generally not destabilizing to the DRUJ, while Type 1B (peripheral), 1C (ulnar) and 1D (radial) lesions may destabilize the DRUJ and thus warrant thorough evaluation for instability.
Atzei et al. proposed a treatment-oriented classification for peripheral tears based on DRUJ instability, status of the superficial and foveal attachments of the TFCC, healing potential and DRUJ chondromalacia. Class 1 are superficial tears with minimal DRUJ instability and are treated with a capsular based TFCC repair. Class 2 and 3 have greater DRUJ instability which involves the foveal TFCC attachments, and foveal TFCC repair is the recommended treatment. Class 4 tears have severe DRUJ instability and poor healing potential and are treated with tendon graft reconstruction, while Class 5 tears include any with severe DRUJ arthritis, necessitating a salvage operation.
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