Wrist arthroscopy is a valuable and widely utilized tool in the treatment of triangular fibrocartilage complex (TFCC) injuries. These procedures include synovectomy alone, peri-capsular or transosseous repair, and arthroscopic-assisted reconstruction, and each are associated with specific complications. This review describes the types of complications and their rates in different types of arthroscopic TFCC surgery reported in the literature and in our centre. Across the spectrum of arthroscopic TFCC surgery, complication rates and the learning curve increase with surgical complexity. Relevant anatomy, prevention and management of complications including nerve injury and irritation, extensor tendon injury and tendinitis, fracture, stiffness, and persistence of symptoms or instability are discussed. Vigilance to anatomical details and careful dissection can help to reduce complications that may result in disturbing pain and functional loss.
AdamsBD.Partial excision of the triangular fibrocartilage complex articular disk: a biomechanical study. J Hand Surg Am. 1993,
18: 334–40.
2.
AndersonMLLarsonANMoranSLCooneyWPAmramiKKBergerRA.Clinical comparison of arthroscopic versus open repair of triangular fibrocartilage complex tears. J Hand Surg Am. 2008,
33: 675–82.
3.
AtzeiA.New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability. J Hand Surg Eur Vol. 2009,
34: 582–91.
BeredjiklianPKBozentkaDJLeungYLMonaghanBA.Complications of wrist arthroscopy. J Hand Surg Am. 2004,
29: 406–11.
6.
ChenTHEWeiJDHuangVW.Injury of the dorsal sensory branch of the ulnar nerve as a complication of arthroscopic repair of the triangular fibrocartilage. J Hand Surg Br. 2006,
31: 530–2.
FeitzRStipDvan der OestMSouerSHoviusSSellesR.Prognostic factors in open triangular fibrocartilage complex (tfcc) repair. J Hand Surg Glob Online. 2021,
3: 176–81.
16.
GiddinsGShewringDDowningN.Articular cartilage and soft tissue damage from radiofrequency thermal ablation wands at wrist arthroscopy. J Hand Surg Eur Vol. 2021,
46: 632–6.
17.
JungHSKimSHJungCWWooSJKimJPLeeJS.Arthroscopic transosseous repair of foveal tears of the triangular fibrocartilage complex: A systematic review of clinical outcomes. Arthroscopy. 2021,
37: 1641–50.
18.
KungTALanghalsNBMartinDCJohnsonPJCedernaPSUrbanchekMG.Regenerative peripheral nerve interface viability and signal transduction with an implanted electrode. Plast Reconstr Surg. 2014,
133: 1380–94.
19.
LeclercqCMathoulinC.Complications of wrist arthroscopy: A multicenter study based on 10,107 arthroscopies. J Wrist Surg. 2016,
5: 320–6.
20.
LourieGMKingJKleinmanWB.The transverse radioulnar branch from the dorsal sensory ulnar nerve: Its clinical and anatomical significance further defined. J Hand Surg Am. 1994,
19: 241–5.
21.
LuchettiRAtzeiA.Arthroscopic assisted tendon reconstruction for triangular fibrocartilage complex irreparable tears. J Hand Surg Eur Vol. 2017,
42: 346–51.
22.
MakCKMHoPC.Arthroscopic-assisted triangular fibrocartilage complex reconstruction. Hand Clin. 2017,
33: 625–37.
23.
NakamuraTSatoKOkazakiMToyamaYIkegamiH.Repair of foveal detachment of the triangular fibrocartilage complex: Open and arthroscopic transosseous techniques. Hand Clin. 2011,
27: 281–90.
24.
NguyenMKBourgouinSGaillardC, et al.
Accidental section of the ulnar nerve in the wrist during arthroscopy. Arthroscopy. 201127: 1308–11.
25.
OkudaMSatoKMimataYMurakamiKTakahashiGDoitaM.Morphology of the ulnar insertion of the triangular fibrocartilage complex and related osseous landmarks. J Hand Surg Am. 2021,
46: 625.e1–.e7.
26.
OngMTHoPCWongCWChengSHTseWL.Wrist arthroscopy under portal site local anesthesia (psla) without tourniquet. J Wrist Surg. 2012,
1: 149–52.
ParkJHLimJWKwonYWKangJWChoiICParkJW.Functional outcomes are similar after early and late arthroscopic one-tunnel transosseous repair of triangular fibrocartilage complex foveal tears. Arthroscopy. 2020,
36: 1845–52.
29.
PellRFTUhlRL.Complications of thermal ablation in wrist arthroscopy. Arthroscopy. 2004,
20 Suppl 2: 84–6.
SaitoTMalaySChungKC.A systematic review of outcomes after arthroscopic débridement for triangular fibrocartilage complex tear. Plast Reconstr Surg. 2017,
140: 697e–708e.
32.
ShyamalanGJordanRWKimaniPKLiverneauxPAMathoulinC.Assessment of the structures at risk during wrist arthroscopy: A cadaveric study and systematic review. J Hand Surg Eur Vol. 2016,
41: 852–8.
33.
TindallAPatelMFrostAParkinIShettyACompsonJ.The anatomy of the dorsal cutaneous branch of the ulnar nerve - a safe zone for positioning of the 6R portal in wrist arthroscopy. J Hand Surg Br. 2006,
31: 203–5.
34.
VossJRLuYEdwardsRBBogdanskeJJMarkelMD.Effects of thermal energy on chondrocyte viability. Am J Vet Res. 2006,
67: 1708–12.
