Traumatic triangular fibrocartilage complex tears in the athlete: results after arthroscopic treatment.

Introduction Traumatic triangular fibrocartilage complex tears are typical of contact sports and the mechanism is commonly a twisting/ rotational wrist trauma. These ruptures, which are common causes of ulnar-sided wrist pain, may be particularly disabling. There are only a few general discussions in the literature about this topic related to sport. Treatment options of TFCC injuries vary along a wide spectrum based on acuteness and location of the tear as well as associated osseous and capsular-ligamentous lesions. The aim of this study was to define the correct approach in the treatment of these lesions in competitive athletes who require a high level of wrist function for performance and to evaluate the results of arthroscopic treatment in this type of patients. Materials and methods Between January 2006 and December 2010, 10 athletes, who responded poorly to non-operative treatment, underwent wrist arthroscopy. Repair or debridement was selected according to the location of the rupture, which was divided using the Palmer classification. After surgery all patients underwent 6 weeks of immobilization and similar rehabilitation protocol. Pre-surgery and follow-up Modified Mayo Wrist Score and Patient Rated Wrist/Hand Evaluation were recorded. Results Ruptures were repaired in 7 patients and debrided in 3. Both scores improved in all cases thus allowing return to sport after a mean period of 3.5 months from surgery. In 1 patient with an associated positive ulnar variance and initial chondromalacia of the ulnar head return to play was delayed to 8 months. Discussion Arthroscopic treatment of traumatic fibrocartilage complex injuries allowed return to athletic competition at a pre-injury level in all cases. Return to sport may be influenced or delayed in athletes with associated ulnar sided osseous and/or capsular-ligamentous wrist conditions. Conclusions In high-level athletes arthroscopic surgery has to be considered the treatment of choice. A more aggressive postoperative rehabilitation protocol could be performed after debridement alone, thus allowing an earlier return to sport