The Efficacy of Transosseous Foveal Repair Combined With Dorsal Reinforcement in the Treatment of Chronic Triangular Fibrocartilage Complex Injury With Severe Distal Radioulnar Joint Instability.

PURPOSE: Mere triangular fibrocartilage complex (TFCC) foveal repair might not be sufficient to yield a favorable prognosis in severe distal radioulnar (DRU) joint instability. In this study, we aimed to evaluate the efficacy of allogeneic tendon graft reinforcement for dorsal structure repair following arthroscopically assisted transosseous foveal reconstruction. METHODS: A total of 21 patients were enrolled in the study, and the mean follow-up duration was 44.5 months. Clinical outcomes were evaluated using multiple assessment tools, including the visual analog scale pain score, grip strength, modified Mayo wrist score, and patient-rated wrist evaluation (PRWE) score. RESULTS: All patients had a notable reduction of wrist pain at the final follow-up with the mean visual analog scale pain score decreased from 5.5 to 0.7. The grip strength increased from 75.1% to 86.6% compared with the unaffected side. The modified Mayo wrist score increased from 68.9 to 90.3 and the PRWE score decreased from 50.4 to 8.9. Using a PRWE score decrease of 24 points or more as the criterion, all patients showed clinically meaningful improvements. CONCLUSIONS: In this uncontrolled case series, transosseous TFCC foveal repair combined with dorsal DRU joint reinforcement was associated with favorable clinical outcomes in patients with chronic TFCC injury and severe DRU joint instability. Comparative studies are required to determine whether the addition of dorsal reinforcement is superior to isolated foveal repair. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.