Pace Valerio, Bronzini Francesco, Novello Giovanni, Mosillo Giuseppe, Braghiroli Luca
Department of Trauma and Orthopaedics, AOSP Terni, Terni 05100, Italy.
Department of Trauma and Orthopaedics, University of Perugia, Perugia 06100, Italy.
World J Orthop. 2024 Feb 18;15(2):110-117. doi: 10.5312/wjo.v15.i2.110.
Triangular fibrocartilage complex injuries are common in amateur and professional sports. These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist, particularly on the ulnar side and in association with rotations or radial/ulnar deviations. In order to treat professional athletes, a detailed specific knowledge of the pathology is needed. Moreover, the clinician should fully understand the specific and unique environment and needs of the athletes, their priorities and goals, the type of sport, the time of the season, and the position played. An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon. A compromise between conservative surgical indications, athletes' needs and expectations, and financial implications should be achieved. Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time. Conservative measures are often used as first line treatment when possible. Peripheral lesions are treated by arthroscopic repair, whilst central lesions are treated by arthroscopic debridement. Further procedures (such as the Wafer procedure, ulnar osteotomies, ) have specific indications and great implications with regard to rehabilitation.
三角纤维软骨复合体损伤在业余和职业运动中很常见。这些损伤主要由手腕上的急性或慢性重复性轴向负荷引起,特别是在尺侧,且与旋转或桡偏/尺偏有关。为了治疗职业运动员,需要对病理学有详细的专业知识。此外,临床医生应充分了解运动员的特殊和独特环境及需求、他们的优先事项和目标、运动类型、赛季时间以及所担任的位置。早期诊断和以最快的恢复时间进行适当管理是运动员和外科医生的首要目标。应在保守手术指征、运动员的需求和期望以及经济影响之间达成妥协。当有指征时,应及时规划关节镜手术,因为这可以同时实现早期诊断和治疗。保守措施在可能的情况下通常用作一线治疗。周边损伤通过关节镜修复治疗,而中央损伤则通过关节镜清创治疗。进一步的手术(如硅胶片手术、尺骨截骨术等)在康复方面有特定的指征和重大影响。