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Degeneration Process of Symptomatic Central Tears in the Triangular Fibrocartilage

Unglaub, Frank MD*†; Hahn, Peter MD, PhD; Wolf, Elke BS; Germann, Guenter MD, PhD*; Bickert, Berthold MD*; Sauerbier, Michael MD, PhD*

doi: 10.1097/01.sap.0000258958.46054.e6
Original Article
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Very little is known about the degeneration or healing process in traumatic triangular fibrocartilage complex (TFCC) lesions. Forty-two patients with symptomatic central traumatic tears in the TFCC (Palmer 1 A) were included in this study. The cartilage was debrided arthroscopically and used for histologic examination. Histologic sections were stained with hematoxylin and eosin (HE) and furthermore, with collagen I and II antibodies. The histologic findings were compared with degenerative findings in 12 patients with degenerative TFCC (Palmer 2 C) lesions.

In patients with recent trauma (<18 months), we mostly found no degenerative changes or only moderate changes, located in the inner part of the tissue. In patients with trauma having occurred more than 18 months ago, the typical degeneration phenomena were mostly extensive and pervasive throughout the entire specimen and similar to our control group (Palmer 2 C). The immunohistochemistry examination showed that in patients having suffered trauma within the last 18 months, the staining for collagen I and II was more intensive than in patients with trauma having occurred more than 18 months ago. The collagen I and II staining in the control group (Palmer 2 C) was weaker, too.

Degeneration phenomena can be found in patients with trauma having occurred more than 18 months ago. The degree of degeneration correlated with the length of time passed since the occurrence of trauma.

Arthroscopic debridement of 42 symptomatic tears of the triangular fibrocartilage complex demonstrated microscopic evidence of degenerative changes in all traumatic lesions over 18 months of age but only moderate changes if the trauma was more recent.

From the *Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University of Heidelberg, Ludwigshafen, Germany; and †Handsurgery, Vulpiusklinik, Bad Rappenau, Germany.

Received November 18, 2006 and accepted for publication, after revision, December 27, 2006.

The study was supported by the Albert-J.B.-Sturm Stiftung, Villingen-Schwenningen, Germany.

Reprints: F. Unglaub, MD, Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University Heidelberg, Ludwig-Guttmannstr. 13, 67071 Ludwigshafen, Germany. E-mail: Frank_Unglaub@web.de.

© 2007 Lippincott Williams & Wilkins, Inc.