Arthroscopic Debridement of Central Triangular Fibrocartilage Complex (TFCC) Tears: a Technical Trick
TFCC tears are a common causes of ulnar-sided wrist pain, which remains a diagnostic challenge due to the highly complex anatomy in this area. Tears of the TFCC can be classified according to mechanism (traumatic or degenerative) or by region (central or peripheral). In this video, we discuss the case of a 24 year-old right handed male who was a high-level football player with left ulnar-sided wrist pain found to have a central TFCC tear. He had initially tried a period of immobilization, which did not help his symptoms, thus was indicated for wrist arthroscopy. We present a technical trick involving the use of the sharp end of an 18 gauge needle to aid in cutting and subsequent debridement of central TFCC tears. This method allows for a precise debridement of frayed edges and carves out a section of frayed TFCC that can subsequently be removed with a shaver or biter. In addition, it allows the surgeon to avoid having to switch portals in order to facilitate debridement of the ulnar aspect of the TFCC.