Video of TFCC Repair Under Wrist Arthroscopy
Mar 17, 2023
Source: Cainiu Health
Dr. Xu Shuai
Introduction
The patient was placed supine on the operating table. After anesthesia, the surgeon made an incision at the patient's wrist and inserted a wrist arthroscope. Another incision was made in the skin at the base of the ulnar styloid, through which a tunnel was drilled using a hollow drill. A micro-suture passer was used to introduce a fiberwire suture and a metallic suture loop. The suture was passed through the loop, and then the loop was pulled out to complete the suturing.
TFCC repair is a surgical procedure that connects the forearm bones to the wrist bones, typically performed under wrist arthroscopy. The surgery should be conducted in a formal medical facility, with specific steps as follows:
1. The patient lies supine on the operating table with the elbow flexed at 90°. The operative hand is suspended using a traction device, and the index and middle fingers are covered with sterile finger traps.
2. The anesthesiologist administers local anesthesia at the patient's wrist. After the anesthesia takes effect, the surgeon makes two small minimally invasive incisions in the wrist area and inserts a wrist arthroscope through one of the incisions.
3. A small incision is made at the base of the ulnar styloid process on the skin. Forceps and surgical scissors are used to dissect the subcutaneous tissue.
4. A dilator is used to open the incision. A guide wire is placed at the midpoint between the palmar and dorsal sides. Under fluoroscopic guidance, the starting point and trajectory are confirmed, then inserted to determine the final position. Finally, a tunnel is drilled using a hollow drill.
5. Retrieve the micro-suture lasso and bend the fiber rod outside the lasso.
6. Pass the micro-suture lasso through the tunnel into the periphery of the TFCC. Rotate it at the origin to form a spherical configuration with the fiber rod suture, then slowly withdraw the suture lasso, leaving the suture in place.
7. Load a metal lasso ring onto the suture lasso, bend the front end of the suture lasso, and reinsert it into the periphery of the TFCC.
8. Retract the suture lasso, leaving the lasso ring behind. Use a micro-suturing hook to retrieve the suture and the lasso ring.
9. Thread the suture through the lasso ring, then pull out the lasso ring to complete the suturing.
10. Repeat the above steps to perform another suture at the periphery of the TFCC. The surgery is now complete.
After surgery, patients should rest adequately and avoid lifting heavy objects.
