The Natural Course of Traumatic Triangular Fibrocartilage Complex Tears in Distal Radial Fractures: A 13-15 Year Follow-up of Arthroscopically Diagnosed but Untreated Injuries.
(2012) In The Journal of Hand Surgery 37(8). p.1555-1560- Abstract
- PURPOSE:
To evaluate the long-term results of a prospective, longitudinal case series of untreated, traumatic triangular fibrocartilage complex (TFCC) tears found in displaced distal radial fractures.
METHODS:
Between 1995 and 1997, 51 patients (24 men, 27 women; age, 20-57 y) with a displaced distal radius fracture had wrist arthroscopy to identify associated injuries. Forty-three patients had complete or partial tears of the TFCC, which were not treated. All patients were contacted in 2010, 13-15 years after the injury. One patient had had a TFCC reattachment due to painful distal radioulnar joint instability and was excluded. Thirty-eight patients returned for a radiographic and clinical follow-up... (More) - PURPOSE:
To evaluate the long-term results of a prospective, longitudinal case series of untreated, traumatic triangular fibrocartilage complex (TFCC) tears found in displaced distal radial fractures.
METHODS:
Between 1995 and 1997, 51 patients (24 men, 27 women; age, 20-57 y) with a displaced distal radius fracture had wrist arthroscopy to identify associated injuries. Forty-three patients had complete or partial tears of the TFCC, which were not treated. All patients were contacted in 2010, 13-15 years after the injury. One patient had had a TFCC reattachment due to painful distal radioulnar joint instability and was excluded. Thirty-eight patients returned for a radiographic and clinical follow-up that recorded strength, distal radioulnar joint laxity, range of motion, pain scale score, and subjective and objective outcome scores.
RESULTS:
After 13-15 years, 17/38 patients were lax in the distal radioulnar joint. The mean grip strength was worse in the patients with a lax distal radioulnar joint (83%, SD 15 of the contralateral side vs 103%, SD 33). The median Gartland and Werley score was 5 (good; range, 0-15) in the lax group compared to 1 (excellent; range, 0-9) in the non-lax group, and the median Disabilities of the Arm, Shoulder, and Hand scores were 14 (range, 0-59) and 5 (range, 0-70) respectively.
CONCLUSIONS:
In this 13-15 year, prospective, longitudinal outcome study of the natural course of TFCC tears associated with distal radius fracture, only 1 patient had been operated on for painful instability since the injury. The subjective and objective results did not provide evidence that a TFCC injury would influence the long-term outcome. However, trends were found and, by speculation, the low number of patients in the series and the risk for a type II error could be the cause of absent statistically significance. Larger, preferably prospective, randomized studies are needed to find out whether a more aggressive treatment is beneficial.
TYPE OF STUDY/LEVEL OF EVIDENCE:
Diagnostic I. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/2966533
- author
- Mrkonjic, Ante LU ; Geijer, Mats LU ; Lindau, Tommy and Tägil, Magnus LU
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- in
- The Journal of Hand Surgery
- volume
- 37
- issue
- 8
- pages
- 1555 - 1560
- publisher
- Elsevier
- external identifiers
-
- wos:000307260200005
- pmid:22835585
- scopus:84864232751
- ISSN
- 1531-6564
- DOI
- 10.1016/j.jhsa.2012.05.032
- language
- English
- LU publication?
- yes
- id
- e7b2ff59-4aad-4dfb-9cc7-1059aabf7d4a (old id 2966533)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/22835585?dopt=Abstract
- date added to LUP
- 2016-04-04 09:40:13
- date last changed
- 2022-04-23 21:38:56
@article{e7b2ff59-4aad-4dfb-9cc7-1059aabf7d4a,
abstract = {{PURPOSE:<br/><br>
To evaluate the long-term results of a prospective, longitudinal case series of untreated, traumatic triangular fibrocartilage complex (TFCC) tears found in displaced distal radial fractures.<br/><br>
<br/><br>
METHODS:<br/><br>
Between 1995 and 1997, 51 patients (24 men, 27 women; age, 20-57 y) with a displaced distal radius fracture had wrist arthroscopy to identify associated injuries. Forty-three patients had complete or partial tears of the TFCC, which were not treated. All patients were contacted in 2010, 13-15 years after the injury. One patient had had a TFCC reattachment due to painful distal radioulnar joint instability and was excluded. Thirty-eight patients returned for a radiographic and clinical follow-up that recorded strength, distal radioulnar joint laxity, range of motion, pain scale score, and subjective and objective outcome scores.<br/><br>
<br/><br>
RESULTS:<br/><br>
After 13-15 years, 17/38 patients were lax in the distal radioulnar joint. The mean grip strength was worse in the patients with a lax distal radioulnar joint (83%, SD 15 of the contralateral side vs 103%, SD 33). The median Gartland and Werley score was 5 (good; range, 0-15) in the lax group compared to 1 (excellent; range, 0-9) in the non-lax group, and the median Disabilities of the Arm, Shoulder, and Hand scores were 14 (range, 0-59) and 5 (range, 0-70) respectively.<br/><br>
<br/><br>
CONCLUSIONS:<br/><br>
In this 13-15 year, prospective, longitudinal outcome study of the natural course of TFCC tears associated with distal radius fracture, only 1 patient had been operated on for painful instability since the injury. The subjective and objective results did not provide evidence that a TFCC injury would influence the long-term outcome. However, trends were found and, by speculation, the low number of patients in the series and the risk for a type II error could be the cause of absent statistically significance. Larger, preferably prospective, randomized studies are needed to find out whether a more aggressive treatment is beneficial.<br/><br>
<br/><br>
TYPE OF STUDY/LEVEL OF EVIDENCE:<br/><br>
Diagnostic I.}},
author = {{Mrkonjic, Ante and Geijer, Mats and Lindau, Tommy and Tägil, Magnus}},
issn = {{1531-6564}},
language = {{eng}},
number = {{8}},
pages = {{1555--1560}},
publisher = {{Elsevier}},
series = {{The Journal of Hand Surgery}},
title = {{The Natural Course of Traumatic Triangular Fibrocartilage Complex Tears in Distal Radial Fractures: A 13-15 Year Follow-up of Arthroscopically Diagnosed but Untreated Injuries.}},
url = {{http://dx.doi.org/10.1016/j.jhsa.2012.05.032}},
doi = {{10.1016/j.jhsa.2012.05.032}},
volume = {{37}},
year = {{2012}},
}