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World J Orthop. Feb 18, 2024; 15(2): 110-117
Published online Feb 18, 2024. doi: 10.5312/wjo.v15.i2.110
Review and update on the management of triangular fibrocartilage complex injuries in professional athletes
Valerio Pace, Francesco Bronzini, Giovanni Novello, Giuseppe Mosillo, Luca Braghiroli
Valerio Pace, Department of Trauma and Orthopaedics, AOSP Terni, Terni 05100, Italy
Francesco Bronzini, Giovanni Novello, Department of Trauma and Orthopaedics, University of Perugia, Perugia 06100, Italy
Giuseppe Mosillo, Luca Braghiroli, Department of Trauma and Orthopaedics, Hand Unit, AOSP Terni, Terni 05100, Italy
Author contributions: Pace V designed the article; Pace V, Bronzini F, Novello G, Mosillo G and Braghiroli L performed research and literature review, analyzed data, wrote and finalized the review.
Conflict-of-interest statement: No conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Valerio Pace, MBBS, MSc, Researcher, Senior Research Fellow, Surgeon, Department of Trauma and Orthopaedics, AOSP Terni, London HA7 4LP, Terni 05100, Italy. valeriopace@doctors.org.uk
Received: October 20, 2023
Peer-review started: October 20, 2023
First decision: October 24, 2023
Revised: October 30, 2023
Accepted: December 14, 2023
Article in press: December 14, 2023
Published online: February 18, 2024
Processing time: 109 Days and 6.3 Hours
Abstract

Triangular fibrocartilage complex injuries are common in amateur and professional sports. These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist, particularly on the ulnar side and in association with rotations or radial/ulnar deviations. In order to treat professional athletes, a detailed specific knowledge of the pathology is needed. Moreover, the clinician should fully understand the specific and unique environment and needs of the athletes, their priorities and goals, the type of sport, the time of the season, and the position played. An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon. A compromise between conservative vs surgical indications, athletes’ needs and expectations, and financial implications should be achieved. Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time. Conservative measures are often used as first line treatment when possible. Peripheral lesions are treated by arthroscopic repair, whilst central lesions are treated by arthroscopic debridement. Further procedures (such as the Wafer procedure, ulnar osteotomies, etc.) have specific indications and great implications with regard to rehabilitation.

Keywords: Triangular fibrocartilage complex injuries; Professional athletes; Ulnar sided wrist pain; Wrist arthroscopy; Wrist debridement

Core Tip: Triangular fibrocartilage complex injuries are common in amateur and professional sports. These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist, particularly on the ulnar side and in association with rotations or radial/ulnar deviations. In order to treat professional athletes, a detailed specific knowledge of the pathology is needed. Moreover, the clinician should fully understand the specific and unique environment and needs of the athletes, their priorities and goals, the type of sport, the time of the season, and the position played. Conservative and surgical management are based on the latter aspects.