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Arthroscopic Repair of the Triangular Fibrocartilage Complex

The triangular fibrocartilage complex (TFCC) spans and supports the distal radioulnar joint and ulnocarpal articulations. The components of the TFCC include the volar and dorsal radioulnar ligaments, articular disc, sheath of the extensor carpi ulnaris tendon, ulnocarpal ligaments, and meniscus homologue. The accurate diagnosis of injuries to the TFCC depends on a combination of physical examination and imaging modalities. Arthroscopy plays a role in both the diagnosis and treatment of injuries to the TFCC. The management of acute and chronic injuries to the TFCC ranges from nonsurgical treatment to open repair. In cases of severe degenerative disease, ulnar resection may be indicated. This article is a review of the pertinent pathophysiology, diagnosis, and management of injuries to the TFCC with a focus on arthroscopic and open surgical techniques.

In-office Carpal Tunnel Release

Carpal tunnel release can be done effectively and safely with minimal resources in an office setting as opposed to the operating room. We successfully used in-office carpal tunnel release with local anesthesia and without the need for a tourniquet, sedation, or the full complement of surgical staff at a local Veteran Administration medical center. This article describes our protocol for patient selection, surgical setup, and technique for in-office carpal tunnel release.

Management of Injuries to the Triangular Fibrocartilage Complex

The triangular fibrocartilage complex (TFCC) spans and supports the distal radioulnar joint and ulnocarpal articulations. The components of the TFCC include the volar and dorsal radioulnar ligaments, articular disc, sheath of the extensor carpi ulnaris tendon, ulnocarpal ligaments, and meniscus homologue. The accurate diagnosis of injuries to the TFCC depends on a combination of physical examination and imaging modalities. Arthroscopy plays a role in both the diagnosis and treatment of injuries to the TFCC. The management of acute and chronic injuries to the TFCC ranges from nonsurgical treatment to open repair. In cases of severe degenerative disease, ulnar resection may be indicated. This article is a review of the pertinent pathophysiology, diagnosis, and management of injuries to the TFCC with a focus on arthroscopic and open surgical techniques.