Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Korea.
Arch Orthop Trauma Surg. 2012 May;132(5):671-6. doi: 10.1007/s00402-011-1416-0. Epub 2011 Nov 11.
Persistent ulnar-sided wrist pain after treatment of triquetral dorsal chip fracture even after union is a matter of concern. There could be various reasons for this persistent pain like arthritis, instability, fractures and non-union. We correlate our findings of physical examination and wrist arthroscopy as triangular fibrocartilage complex injury to be one of the causes of this persistent pain.
Six subjects who had persistent ulnocarpal joint pain and tenderness after triquetral dorsal chip fracture, despite 2 months of conservative treatment, were subjected to physical tests. If the physical examination yields positive results, then magnetic resonance imaging followed by arthroscopic treatment was performed. The six patients were then evaluated using the visual analogue scale, the Mayo modified wrist score, and the grip strength test.
Triangular fibrocartilage complex (TFCC) injury was observed in all six cases and partial TFCC resection and synovectomy were performed. Analysis of the visual analogue scale, Mayo modified wrist score, and grip strength test data revealed statistically significant improvements (P < 0.05).
In addition to several causes reported in the published literature, TFCC injury can be a cause of persistent ulnar pain after treatment of triquetral dorsal chip fracture. Arthroscopic partial TFCC resection can be considered to be a suitable treatment for such cases.
即使在愈合后，治疗三角骨背侧骨块骨折后仍持续存在的尺侧腕部疼痛仍然令人担忧。这种持续疼痛可能有多种原因，如关节炎、不稳定、骨折和不愈合。我们通过体格检查和腕关节镜检查发现，三角纤维软骨复合体（TFCC）损伤是导致这种持续性疼痛的原因之一。
六名患有三角骨背侧骨块骨折后持续尺侧腕关节疼痛和压痛的患者，尽管接受了 2 个月的保守治疗，但仍接受了体格检查。如果体格检查结果阳性，则进行磁共振成像检查，然后进行关节镜治疗。然后使用视觉模拟量表、改良 Mayo 腕关节评分和握力测试对这 6 名患者进行评估。
在所有 6 例中均观察到 TFCC 损伤，并进行了 TFCC 部分切除术和滑膜切除术。视觉模拟量表、改良 Mayo 腕关节评分和握力测试数据分析显示有统计学意义的改善（P<0.05）。
除了文献中报道的几种原因外，TFCC 损伤也可能是三角骨背侧骨块骨折治疗后持续尺侧疼痛的原因。关节镜下 TFCC 部分切除术可被视为此类病例的一种合适治疗方法。
