Management of distal radius fracture-associated TFCC lesions without DRUJ instability

Abstract

Fractures of the distal end of radius account for nearly 20% of all fractures seen in a routine emergency room and are commonly associated with intercarpal ligamentous injuries and other soft tissue disruptions [6]. The structure most frequently injured in distal radial fractures is the triangular fibrocartilage complex (TFCC) [15, 21, 24, 27]. In one cadaveric study where a hyperextension force was applied to cadaveric wrists until a distal radial fracture occurred, an injury to the TFCC occurred in 63% of the specimens followed by injuries to scapholunate ligament (32%) and to lunotriquetral ligament (17%) [20]. The TFCC consists of the central fibrocartilage, the dorsal and palmar distal radioulnar ligaments, the sheath of extensor carpi ulnaris tendon, the ulnar collateral ligaments, and the ulnocarpal ligaments. It works as a single unit that aids in movements, stability, and load sharing at the wrist. The central area of TFCC is avascular and called the debridement zone, whereas, the peripheral zone enjoys an extensive blood supply and is termed the repair zone [25] (Fig. 5.1). © 2010 Springer-Verlag Berlin Heidelberg.