All-Arthroscopic Triangular Fibrocartilage Complex Ligamentoplasty for Chronic DRUJ Instability

摘要

Peripheral injuries of the triangular fibrocartilage complex can produce pain and instability of the distal radioulnar joint (DRUJ). There are several techniques for the repair or reconstruction of these injuries, which vary depending on the location, healing capacity, and viability of the tissues, as described by the classification proposed by Atzei. In irreparable chronic injuries of the triangular fibrocartilage complex in which there are no associated chondral injuries of the DRUJ or in failures in previous repair techniques, ligament reconstruction plasty with tendon grafts, either by open surgery or assisted by arthroscopy, are the treatments of choice. We present a completely arthroscopic reconstruction technique of the triangular fibrocartilage complex by means of tendon graft to provide stability to the DRUJ. This reconstruction technique provides a more stable reconstruction after the integration of the tendon plasty in the bone tunnels, based on the anatomic insertions of the triangular fibrocartilage in the fovea and in the corners of the dorsal and volar sigmoid notch, along with the advantages offered by arthroscopy in terms of recovery time, esthetic result, less mobility loss, and pain.