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Tenodesis of the Ulnotriquetrum Ligament to the Fovea for a Triangular Fibrocartilage Complex Tear

Moritomo, Hisao, MD, PhD*; Arimitsu, Sayuri, MD, PhD

Techniques in Hand & Upper Extremity Surgery: December 2018 - Volume 22 - Issue 4 - p 141–145
doi: 10.1097/BTH.0000000000000212
Techniques

We developed a novel procedure to treat a triangular fibrocartilage complex (TFCC) foveal tear, namely tenodesis of the ulnotriquetrum ligament (UTL) to the fovea. We attempted to reestablish the tension of the palmar radioulnar ligament by the procedure specifically in cases with palmar radius instability relative to the ulna. We used a palmar surgical approach to expose the palmar aspect of TFCC in which the ulnocarpal ligament merges with the palmar radioulnar ligament. UTL was distally excised at a 4 mm width from the triquetrum without disrupting its ligamentous connection to the palmar radioulnar ligament proximally. We pulled out the distal UTL through the bone tunnel from the fovea to ulnar neck. The UTL graft was fixed to the fovea with an interference screw. In 13 cases, this procedure effectively decreased ulnar wrist pain, improved distal radioulnar joint instability, and restored wrist motion and grip strength.

*Osaka Yukioka College of Health Science

Yukioka Hospital Hand Center, Osaka, Japan

The authors report no conflicts of interest.

Address correspondence and reprint requests to Hisao Moritomo, MD, PhD, Yukioka Hospital Hand Center, Osaka Yukioka college of Health Science, 2-2-3, Ukita, Kita-ku, Osaka-shi, Osaka 530-0021, Japan. E-mail: hisao-moritomo@yukioka-u.ac.jp.

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