JHS - 2026-08-22 - Journal Article
The Efficacy of Transosseous Foveal Repair Combined With Dorsal Reinforcement in the Treatment of Chronic Triangular Fibrocartilage Complex Injury With Severe Distal Radioulnar Joint Instability.
Zhang W, Wu T, Wang C, Ho PC, Sun L, Hou P
Topics
Key Takeaway
Transosseous TFCC foveal repair combined with allogeneic tendon dorsal DRUJ reinforcement reduced mean VAS from 5.5 to 0.7 and improved modified Mayo wrist score from 68.9 to 90.3 at mean 44.5-month follow-up in 21 patients with chronic severe DRUJ instability.
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Summary
This study evaluated arthroscopically assisted transosseous TFCC foveal repair augmented with allogeneic tendon dorsal DRUJ reinforcement in 21 patients with chronic TFCC injury and severe DRUJ instability. Grip strength improved from 75.1% to 86.6% of the contralateral side, PRWE decreased from 50.4 to 8.9, and all patients met the 24-point PRWE minimal clinically important difference threshold. No control arm was included, precluding determination of whether dorsal augmentation adds benefit over isolated foveal repair.
Key Limitation
The absence of a control group receiving isolated foveal repair makes it impossible to attribute the favorable outcomes to the dorsal reinforcement component rather than the foveal reconstruction alone.
Original Abstract
PURPOSE
Mere triangular fibrocartilage complex (TFCC) foveal repair might not be sufficient to yield a favorable prognosis in severe distal radioulnar (DRU) joint instability. In this study, we aimed to evaluate the efficacy of allogeneic tendon graft reinforcement for dorsal structure repair following arthroscopically assisted transosseous foveal reconstruction.
METHODS
A total of 21 patients were enrolled in the study, and the mean follow-up duration was 44.5 months. Clinical outcomes were evaluated using multiple assessment tools, including the visual analog scale pain score, grip strength, modified Mayo wrist score, and patient-rated wrist evaluation (PRWE) score.
RESULTS
All patients had a notable reduction of wrist pain at the final follow-up with the mean visual analog scale pain score decreased from 5.5 to 0.7. The grip strength increased from 75.1% to 86.6% compared with the unaffected side. The modified Mayo wrist score increased from 68.9 to 90.3 and the PRWE score decreased from 50.4 to 8.9. Using a PRWE score decrease of 24 points or more as the criterion, all patients showed clinically meaningful improvements.
CONCLUSIONS
In this uncontrolled case series, transosseous TFCC foveal repair combined with dorsal DRU joint reinforcement was associated with favorable clinical outcomes in patients with chronic TFCC injury and severe DRU joint instability. Comparative studies are required to determine whether the addition of dorsal reinforcement is superior to isolated foveal repair.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV.