Arthroscopic Foveal Reattachment of the Triangular Fibro Cartilaginous Complex (TFCC) with Bone Tunnels and Anchor Fixation

Description

The video presents a detailed case study of an arthroscopic foveal reattachment of the triangular fibrocartilaginous complex (TFCC) in a 37-year-old female patient who presented with foveal pain and a diagnosed TFCC injury. The procedure begins with diagnostic arthroscopy, which confirms the injury alongside preserved trampoline effect and positive ghost sign. A 6U accessory portal is created to allow for the insertion of a wire guide, which is essential for positioning Kirschner wires through the distal ulna.



The surgical steps are meticulously described, involving the passage of nitinol loops and non-absorbable sutures through designated portals while ensuring proper technique to avoid interposition of soft tissues. After confirming fixation of the TFCC by tensioning the sutures, the wrist is stabilized during anchor drilling to prevent complications. Post-operatively, a sugar tong splint is applied, followed by a progressive rehabilitation plan that includes physiotherapy with restricted movements.



Follow-up assessments at two weeks, five weeks, two months, and three months demonstrate significant recovery in wrist motion and function, with the patient able to resume activities, including work as a veterinarian and participation in sports such as swimming and Pilates. Despite some lingering difficulties with weight-bearing activities at three months, the patient shows overall improvement according to the DASH score. The presentation concludes with an assurance of no conflicts of interest.

Specialties