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Outcomes of Operative Treatment of Triangular Fibrocartilage Tears in Pediatric and Adolescent Athletes

Fishman, Felicity G., MD*; Barber, Jarrad, MD; Lourie, Gary M., MD; Peljovich, Allan E., MD, MPH§

doi: 10.1097/BPO.0000000000001243
Sports Medicine

Background: Triangular fibrocartilage complex (TFCC) tears have been treated with increasing frequency in pediatric and adolescent patients over the past decade. There is little information on these injuries in young athletes and a scarcity of data regarding their ability to return to preinjury levels of athletic participation. The purpose of this study was to review the outcomes of pediatric and adolescent athletes with operatively treated TFCC tears with or without a concurrent ulnar shortening osteotomy and to determine their ability to return to their preoperative level of activity.

Methods: A retrospective chart review was performed for all patients who underwent operative treatment of TFCC tears between 2006 and 2012 within one Upper Extremity practice. Patients were included if they were high-level athletes, unable to participate in their sport secondary to wrist pain and desired to return to their sport. All operative patients had imaging studies and clinical findings consistent with TFCC injury as the primary source of their activity-limiting pain and had failed nonoperative management prior to surgery. Patients without at least 3 months of documented postoperative follow up were excluded.

Results: In total, 22 patients were included in the chart review with 20 patients willing to participate in a telephone survey and PODCI. Eighty percent of patients returned to their sport following operative treatment of their injury at an average of 4.8 months. Seven of the 22 patients underwent a concurrent ulnar shortening osteotomy for ulnar positive variance. All 20 patients reported satisfaction with the outcomes of their surgery and treatment.

Conclusions: Operative treatment of TFCC injuries in adolescent and pediatric athletes after failure of conservative treatment allowed return to sport at the previous level of participation. Concurrent ulnar shortening osteotomy in the setting of ulnar positive variance did not prohibit return to high-level athletic participation.

Level of Evidence: Level IV.

*Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL

Department of Orthopaedic Surgery, Atlanta Medical Center

The Hand and Upper Extremity Center of Georgia

§Pediatric Hand & Upper Extremity Center of Georgia, Atlanta, GA

The authors declare no conflicts of interest.

Reprints: Felicity G. Fishman, MD, Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S 1st Avenue, Maguire Center, Building 105, Suite 1700, Maywood, IL 60153. E-mail: felicity.fishman@lumc.edu.

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