Resultados del tratamiento artroscópico de lesiones Atzei 4 del complejo fibrocartílago triangular mediante ligamentoplastia de Carratalá

Abstract

Objective: our purpose was to present the results of the reconstruction of the triangular fibrocartilage complex (TFCC) in Atzei Type 4 chronic lesions, through the arthroscopic reconstruction of Carratalá with palmar minor graft.

Materials and methods: we retrospectively evaluated nine patients with TFCC Atzei 4 lesion. Six males and three females, all in working age. The average follow-up was fourteen months. All lesions were reconstructed arthroscopically by means of a free injection of the palmar minor with radial and ulnar fixation using the Carratalá technique. Range of motion (ROM), grip strength, Mayo wrist score, and DASH score were evaluated.

Results: pain and strength tests were improved, the average ROM was 80° for extension, 80° for flexion with a prono-supination range of motion of 160°. The Mayo wrist score was excellent at 78%, good at 11%, and a poor result at 11%. Regarding the DASH score, the average in the preoperative period was 61 points and in the postoperative period at fourteen months, 9 points. The average comparative contralateral strength was 85%.

Conclusion: the arthroscopic reconstruction of the TFCC in Atzei Type 4 chronic lesions, by means of the Carratalá ligamentoplasty for distal radioulnar certainty, is a minimally invasive arthroscopic variant, replicable with good functional results. As a weakness we have a very low number of patients with a short follow-up.