الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The triangular fibrocartilage complex (TFCC) is a complicated structure located in the ulnar side of the wrist, composed of multiple distinct anatomic structures which together play a critical role in wrist biomechanics. The TFCC acts as the main stabilizing element of the ulnar side of the wrist, and is responsible for transmitting approximately 20% of the forces that cross the wrist when there is neutral ulnar variance. Yet, this structure also allows a remarkable and complex range of motion. TFCC plays an important role in wrist biomechanics, and is prone to traumatic and degenerative injury. Injury to one or more of the structures of the TFCC may lead to ulnar sided wrist instability, pain, and/or clicking, which may lead to disability
Several arthroscopic techniques have been described as all-inside, inside-out and outside-in. In this study we used outside-in technique. Its ease of use and its easy technique, with strong and reliable repair obtained is obviously noted with early clinical outcome with this study’s case series.
We conducted a prospective review of patients with TFCC Palmer 1B tears treated from 2014 to 2018. Patients’ charts were reviewed pre and post-operative. Each patient completed quick Disabilities of the Arm, shoulder, and hand (modified QuickDASH-9) score as well as modified Mayo wrist score questionnaires.
In this study 31 patients were recruited, 18 (58.1%) males and 13 (41.9%) females. Their age ranged from 15 to 57 years with a mean age of 34.87 years old and 10.88 S.D. Sixteen out of 31 patients had the TFCC 1B lesion in their Right wrists and 15 had it in their left wrists, 16 had the problem in their dominant hand and 15 had it in their non-dominant hand. The mean follow-up period is 17.3±5.3 months range (6 -24) months. The mean modified QuickDASH-9 score is 12.78±6.9 (range 8.3 to 41.3). The mean modified Mayo wrist score is 83.07±7.03 (range 45.0 - 95.0). Average time to full activity is 6 months. One patient had intraoperative injury to the dorsal cutaneous branch of the ulnar nerve diagnosed postoperatively and was successfully managed by rehabilitation techniques including desensitization and One other patient had persistent pain due to use of Prolene 2/0 suture in the repair instead of PDS 2/0. Suture removed afterwards.
After a mean of 17.3±5.3 months follow up 30 of 31 patients had a good achievement subjective outcome results based on modified QuickDASH-9 and modified Mayo wrist questionnaires. The short-term results showed that Outside-in arthroscopic repair is safe and effective for repair of Palmer 1B TFCC tears