RESUMEN
The scapholunate ligamentous complex consists of the scapholunate interosseous ligament and the surrounding extrinsic ligamentous system. In cases of chronic scapholunate instability, stabilizing the extrinsic ligaments is crucial. This article presents an arthroscopic capsuloligamentous reinforcement plicature that focuses on tightening the volar scapholunate extrinsic ligaments, namely the radioscaphocapitate ligament and long radiolunate ligament, along with indirect tightening of the volar scapholunate interosseous ligament. Although it may be challenging to differentiate the effect of the volar extrinsic plicature from a dorsal capsular reinforcement when both are applied, the volar extrinsic plicature can serve as a beneficial addition to dorsal capsular reinforcement techniques for complex scapholunate instability.
RESUMEN
The triangular fibrocartilaginous complex is made of multiple components, of which the palmar and dorsal radioulnar ligaments play an important role in distal radioulnar joint stability. The ulnar wrist ligaments may be injured during forearm and wrist trauma. There are several aspects of triangular fibrocartilaginous complex management that are still open to debate. The aim of the present study was to review the current concepts and discuss emerging trends to better elucidate and treat this important ligament complex.Level of evidence: V.
RESUMEN
Introduction The use of wrist arthroscopy has become a prerequisite for diagnosis and treatment of triangular fibrocartilage complex (TFCC) disorders. Since Palmer's landmark paper, many new arthroscopic descriptions of TFCC tears have been published but there is no currently available updated comprehensive arthroscopic classification of TFCC lesions. Purpose We recently described the arthroscopic anatomy of the TFCC as viewed from a 3-4 portal. Our purpose was to propose a new TFCC disorders classification based on this new arthroscopic TFCC description. Methods We included all currently described TFCC disorders to the best of our knowledge into our arthroscopic, functional, and vascular anatomical concept. We also included patient's specific ulnar variance and distal radial ulnar joint coronal inclination as baseline treatment-oriented parameters. The fresh or chronic, reparable or nonreparable nature of some types of TFCC tears were considered as separate parameters. Results The proposed classification includes disc "D" (degenerative or traumatic), reins "R" (traumatic), and wall "W" (traumatic) lesions. Combined lesions of those three parts of the TFCC may be easily identified. This new classification should facilitate future analysis of isolated or combined TFCC disorders whether they are degenerative and/or traumatic. Discussion The authors present a new three-dimensional-three-part arthroscopic updated description of TFCC disorders with relevance to etiology and treatment principles.
