Publication:

Impact of triangular fibrocartilage complex injury in distal radius fracture on functional outcome

Background There is limited clinical data suggesting whether triangular fibrocartilage complex (TFCC) injury, associated with distal radius fracture (DRF), should be diagnosed and treated regularly. This study was conducted to identify the incidence of TFCC injury in DRF and its effects on outcome after fracture healing.

Methods This was a prospective cohort study wherein patients treated for DRF were evaluated for TFCC injury. Data collected at 3 and 6 month follow up included grip strength, range of movement and Patient Rated Wrist Evaluation (PRWE) score. Data from 24 patients with TFCC injury and 26 patients without TFCC injury was analyzed.

Results Out of the total 50 patients with DRF, 48% were diagnosed with TFCC injury using wrist arthrography. Most (58.33%) of which were associated with fractures due to road traffic accidents. A significantly higher proportion of patients reported pain on ulnar deviation (p=0.035) and positive press test (p<0.001) in those with compared to without TFCC injury. The mean PRWE score in those with and without TFCC injury were 27.92±17.61 and 21.15±12.79 respectively. An associated ulnar styloid fracture was observed in ⁓46% patients. There was no statistically significant difference in the outcome measures between the two groups.

Conclusions In our study, the incidence of TFCC injury in DRF was 48%. There was no significant effect of TFCC injury on the functional outcome of wrist after DRF healing. We thereby conclude that routine diagnosis and treatment of TFCC injury in DRF is not essential.