Seoung-Joon Lee; Jin-Ho Hwang; Min-Seok Kang; Jong-Woong Park

doi:10.12671/jkfs.2009.22.3.179

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Original Article
TFCC Injury Associated with the Triquetral Dorsal Chip Fracture: Seoung-Joon Lee, M.D., Jin-Ho Hwang, M.D., Min-Seok Kang, M.D., Jong-Woong Park, M.D.; Journal of the Korean Fracture Society 2009;22(3):179-184.
DOI: https://doi.org/10.12671/jkfs.2009.22.3.179
Published online: July 31, 2009

Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Korea.

^*Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Ansan, Korea.

Address reprint requests to: Seoung-Joon Lee, M.D. Department of Orthopedic Surgery, Konkuk University School of Medicine, 1, Hwayang-dong, Gwangjin-gu, Seoul 143-701, Korea. Tel: 82-2-2030-7360, Fax: 82-2-2030-7369, lsjmd@kuh.ac.kr

• Received: November 16, 2008 • Revised: March 20, 2009 • Accepted: May 2, 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
To evaluate the usefulness of wrist arthroscopic examination in patient with persistent pain after the triquetral dorsal chip fracture and also to determine its relationship with TFCC injury in the triquetral dorsal chip fracture patient manifesting persistent pain.
Materials and Methods
This study is based on six cases presenting persistent pain in the ulnar aspect after the triqeutral posterior cord fracture that were treated conservatively. Wrist arthroscopy was carried out for all six cases. All were preoperatively and postoperatively evaluated using VAS pain scale, grip power, ulnar grind test, Kleinman shearing test and lunotriquetral ballottment test.
Results
Preoperatively, ulnar grind test yielded positive results in all six cases, Kleiman shearing test proved positive in three cases and lunotriquetral ballottment test yielded positive result in one case. In the arthroscopic findings, synovitis and TFCC injury were detected in all cases, and based on Palmer classification of TFCC injury, type IA was determined in five cases and type ID in one case. Arthroscopic TFCC partial resection and synovectomy were carried out. VAS pain scale improved from an average 8 points preoperatively to 3 points postoperatively. The difference of grip power between the normal and the other side improved from average of 15 lb preoperatively to 5 lb postoperatively. Based on postoperatively physical examination at 6 weeks, all cases yielded negative results in the ulnar grind test and Kleiman shearing test.
Conclusion
We think that TFCC injury is one of the causes of persistent pain after triquetral dorsal chip fracture. We recommend an arthroscopic TFCC partial resection as a valuable treatment option.
Key words: Triquetral dorsal chip fracture, TFCC injury, Wrist arthroscopy, Arthroscopic TFCC partial resection

REFERENCES

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Fig. 1

Plain x-ray (A, B) and CT (C) of a 45-year-old man show chip fracture of triquetrum and MRI (D) shows TFCC injury.

Fig. 2

Arthroscopy shows palmer type Ia, TFCC injury (A) with synovitis (B), and SL ligament injury (C).

The (D) shows TFCC after partial resection and debridement.

Fig. 3

VAS pain scale shows the degree of the pain was decreased in length of time.

Table 1

Arthroscopic findings

Table 2

Summary of cases

^*UST: Ulnar stress test, ^†GT: Grind test, ^‡KST: Kleinman shear test, ^§BT: lunotriquetral ballottement test.

Figure & Data

REFERENCES

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TFCC Injury Associated with the Triquetral Dorsal Chip Fracture

J Korean Fract Soc. 2009;22(3):179-184. Published online July 31, 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.3.179

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Figure

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TFCC Injury Associated with the Triquetral Dorsal Chip Fracture

Fig. 1 Plain x-ray (A, B) and CT (C) of a 45-year-old man show chip fracture of triquetrum and MRI (D) shows TFCC injury.

Fig. 2 Arthroscopy shows palmer type Ia, TFCC injury (A) with synovitis (B), and SL ligament injury (C). The (D) shows TFCC after partial resection and debridement.

Fig. 3 VAS pain scale shows the degree of the pain was decreased in length of time.

Fig. 1

Fig. 2

Fig. 3

TFCC Injury Associated with the Triquetral Dorsal Chip Fracture

Table 1

Arthroscopic findings

Table 2

Summary of cases

^*UST: Ulnar stress test, ^†GT: Grind test, ^‡KST: Kleinman shear test, ^§BT: lunotriquetral ballottement test.

Table 1 Arthroscopic findings

Table 2 Summary of cases

^*UST: Ulnar stress test, ^†GT: Grind test, ^‡KST: Kleinman shear test, ^§BT: lunotriquetral ballottement test.