McCarron Luke, Coombes Brooke K, Bindra Randy, Dyer Brett, Watson Steven, Bisset Leanne
Griffith University, Southport, QLD, Australia.
Bond University, Robina, QLD, Australia.
Hand (N Y). 2025 Mar 31:15589447251325821. doi: 10.1177/15589447251325821.
There are many factors that may influence patient recovery following triangular fibrocartilage complex (TFCC) foveal repair surgery. This study aimed to retrospectively analyze patient records following TFCC foveal repair surgery to identify characteristics that predict patient outcomes.
A multicenter, retrospective case-series was conducted. Informed written consent was obtained from participating hand therapy clinics, who provided deidentified patient records for adult patients following TFCC foveal repair surgery between January 1 2015 and December 31 2020. Predictors of outcomes were identified using Linear Mixed Effects Regression and Logistic Regression models.
A total of 210 patients were included. The most notable improvements in range of motion (ROM) and grip strength, and pain reduction, were observed in the first 10 weeks postsurgery. Longer forearm immobilization duration predicted poorer ROM for pronation, flexion, and extension. Workcover (compensable) patients demonstrated poorer ROM progression compared with private patients. Forty-two patients (20%) required further surgery, of which was due to postoperative TFCC rupture for 22 patients (10%). Patients who received a shorter wrist immobilization period were more likely to experience TFCC rupture. The duration of time between injury and operative treatment did not predict ROM, grip strength, or pain progression.
Longer forearm immobilization predicted poorer ROM and grip strength progression, whereas shorter wrist immobilization predicted an increased risk of TFCC rupture. These findings support a staggered commencement of wrist and forearm ROM exercises, whereby forearm rotation exercises could commence earlier than wrist exercises. The duration of time between injury and operative treatment did not predict ROM, grip strength, or pain progression.
三角纤维软骨复合体（TFCC）中央凹修复手术后，有许多因素可能影响患者的恢复。本研究旨在回顾性分析TFCC中央凹修复手术后的患者记录，以确定可预测患者预后的特征。
进行了一项多中心回顾性病例系列研究。从参与的手部治疗诊所获得了知情书面同意书，这些诊所提供了2015年1月1日至2020年12月31日期间接受TFCC中央凹修复手术的成年患者的去识别化患者记录。使用线性混合效应回归和逻辑回归模型确定预后的预测因素。
共纳入210例患者。术后前10周观察到活动范围（ROM）、握力和疼痛减轻方面最显著的改善。前臂固定时间越长，旋前、屈曲和伸展的ROM越差。与自费患者相比，工伤赔偿（可补偿）患者的ROM进展较差。42例患者（20%）需要进一步手术，其中22例患者（10%）是由于术后TFCC破裂。手腕固定时间较短的患者更有可能发生TFCC破裂。受伤与手术治疗之间的时间间隔不能预测ROM、握力或疼痛进展。
前臂固定时间越长，ROM和握力进展越差，而手腕固定时间越短，TFCC破裂风险越高。这些发现支持手腕和前臂ROM练习交错开始，即前臂旋转练习可以比手腕练习更早开始。受伤与手术治疗之间的时间间隔不能预测ROM、握力或疼痛进展。
