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急性创伤性三角纤维软骨复合体(TFCC)撕裂的关节镜检查算法

Arthroscopic algorithm for acute traumatic triangular fibrocartilage complex (TFCC) tears.

作者信息

Chung Sze Ryn, Huan Khian Wan Sarah Joy, Nah Jie Hui, Jerome Terrence Jose

机构信息

Department of Hand Surgery, Singapore General Hospital, Singapore.

Hand and Reconstructive Microsurgery, Olympia Hospital and Research Centre, Trichy, India.

出版信息

J Hand Microsurg. 2024 Nov 14;17(1):100175. doi: 10.1016/j.jham.2024.100175. eCollection 2025 Jan.

Abstract

The triangular fibrocartilage complex (TFCC) is crucial for stability and acts as a shock absorber and load transmitter at the distal radioulnar joint (DRUJ). It is often injured in wrist trauma, particularly in young athletes. Clinical assessment involves patient history, physical examination, and imaging modalities like MRI, with wrist arthroscopy as the gold standard for diagnosing TFCC tears. Multiple classification systems categorize TFCC tears based on location and arthroscopic appearance, guiding treatment decisions. Surgical options are recommended for tears refractory to conservative management or severe tears. Despite numerous arthroscopic treatments available in the literature, this article aims to simplify the approach. It presents the authors' surgical algorithm for managing acute traumatic TFCC tears arthroscopically. The choice of technique depends on the lesion's location, with various options for peripheral and foveal tears. Post-operative rehabilitation is crucial for optimal recovery. This article provides a comprehensive review of acute traumatic TFCC injuries, covering anatomy, classification, assessment, and treatment options. Emphasis is placed on accurate diagnosis and appropriate arthroscopic management through a structured approach.

摘要

三角纤维软骨复合体(TFCC)对于稳定性至关重要,在桡尺远侧关节(DRUJ)处起到减震器和载荷传递的作用。它在腕部创伤中常被损伤,尤其是在年轻运动员中。临床评估包括患者病史、体格检查以及MRI等影像学检查方式,腕关节镜检查是诊断TFCC撕裂的金标准。多种分类系统根据位置和关节镜下表现对TFCC撕裂进行分类,以指导治疗决策。对于保守治疗无效的撕裂或严重撕裂,建议采用手术治疗。尽管文献中有众多关节镜治疗方法,但本文旨在简化治疗方法。它介绍了作者关节镜下处理急性创伤性TFCC撕裂的手术流程。技术的选择取决于损伤的位置,对于周边和中央凹撕裂有多种选择。术后康复对于最佳恢复至关重要。本文全面综述了急性创伤性TFCC损伤,涵盖了解剖、分类、评估和治疗选择。重点在于通过结构化方法进行准确诊断和适当的关节镜处理。

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本文引用的文献

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