Houston Methodist. Leading Medicine

Wrist FAQ

Question:

I know there are always possible complications after any kind of surgery. What kinds of problems can develop after surgery to repair a torn triangle wrist ligament?

Answer:

Triangular fibrocartilage complex (TFCC) injuries of the wrist affect the ulnar (little finger) side of the wrist. Mild injuries of the TFCC may be referred to as a wrist sprain. As the name suggests, the soft tissues of the wrist are complex. The triangular fibrocartilage complex (TFCC) suspends the ends of the radius and ulna bones over the wrist. It is triangular in shape and made up of several ligaments and cartilage. The TFCC makes it possible for the wrist to move in six different directions (bending, straightening, twisting, side-to-side). They work together to stabilize the very mobile wrist joint. Disruption of this area through injury or degeneration can cause more than just a wrist sprain requiring surgical repair. Arthroscopic debridement (smoothing or shaving) of the damaged tissue is then required. The surgeon debrides any tears of the tissue that might catch against other joint surfaces. Then the surgeon looks for any problems with the nearby soft tissues and ligaments. A probe is used to detect tension or laxity (looseness) of the ligaments. Laxity is a sign of injury. Arthroscopic debridement works well for simple tears. Much of the damaged tissue can be removed while still keeping a stable wrist joint. The torn structures can be reattached with repair sutures. Some ligamentous ruptures with fracture require reattachment and instrumentation. Instrumentation refers to the use of hardware such as wires and screws to help hold the repaired tissue in place until healing occurs. Complications following surgery for TFCC tears can be broad-ranging and depend on the location and severity of the tear as well as the type of surgery required. For example, there are higher complication rates when instrumentation is used or if there is a shortening of one of the bones of the forearm. Delayed union, nonunion, infection, and persistent wrist pain and stiffness are the more serious problems that can develop. Nerve injury during the surgery can leave behind persistent numbness, weakness, and deterioration of hand function. Further surgery may be needed to revise the first operation. Some patients need another surgery to remove any hardware used to stabilize the joint. The bottom of the ulna called the styloid may have to be removed. In rare cases, the procedure fails to provide the desired results. A wrist fusion may be the next step. Most of the time the procedure goes well and provides the intended and desired results of pain free motion, restored function, and full strength. It's good to be mentally prepared for all possible outcomes but even better to expect a perfect result right from the start! Chris Y. K. Tang, MBBS, et al. Another Light in the Dark: Review of a New Method for the Arthroscopic Repair of Triangular Fibrocartilage Complex. In The Journal of Hand Surgery. June 2012. Vol. 37A. No. 6. Pp. 1263-1268.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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