{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:39:21Z","timestamp":1790005161544,"version":"4.0.1"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003In recent years, new arthroscopic techniques have been introduced to address the irreparable tears of the triangular fibrocartilage complex (TFCC) (Palmer type 1B, Atzei class 4) by replicating the standard Adams\u2013Berger procedure. These techniques, however, show the same limitations of the open procedure in relation to the anatomically defective location of the radial origins of the radioulnar ligaments (RUL) and the risk of neurovascular and\/or tendon injury. Aiming to improve the quality of reconstruction and reduce surgical morbidity, a novel arthroscopic technique was developed, with the advantages of reproducing the anatomical origins of the RUL ligaments and providing all-inside tendon graft (TG) deployment and fixation.<\/jats:p><jats:p>\n          Description of Technique\u2003The Allinside anatomic arthroscopic (3A) technique is indicated for TG reconstruction of irreparable TFCC tears in the absence of distal radioulnar joint (DRUJ) arthritis. Standard wrist arthroscopy portals are used. A small incision in the radial metaphyseal area and arthroscopic control are required to set a Wrist Drill Guide and create two converging tunnels, whose openings are at the radial anatomical origins of the RUL. An ulnar tunnel is drilled at the fovea from inside-out via the 6U portal. A 3-mm tendon strip, from the palmaris longus or extensor carpi radialis brevis, is woven through the tunnels and then secured into the ulnar tunnel with an interference screw. Postoperative immobilization with restricted forearm rotation is discontinued at 5 weeks, and then postoperative rehabilitation is started.<\/jats:p><jats:p>\n          Patients and Methods\u2003The 3A technique was applied on 5 patients (2 females and 3 males), with an average age 42 years. DRUJ stability, range of motion (ROM), pain (0\u201310 visual analogue scale [VAS]), grip strength, modified Mayo wrist score (MMWS), and patient satisfaction were used for evaluation before surgery and at follow-up.<\/jats:p><jats:p>\n          Results\u2003No intraoperative or early complications were registered. At a mean follow-up of 26 months, DRUJ was stable in all patients, which recovered 99% ROM. Pain VAS decreased from 7 to 0.6. Grip strength increased from 38 to 48.8\u2009Kgs. There were 4 excellent results and 1 good result on MMWS. All patient showed high satisfaction.<\/jats:p><jats:p>\n          Conclusions\u2003Although the 3A technique requires dedicated instrumentation and arthroscopic expertise, it takes advantage of improved intra-articular vision and minimized surgical trauma to reduce the risk of complications and obtain promising functional results.<\/jats:p>","DOI":"10.1055\/s-0041-1735981","type":"journal-article","created":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T08:44:54Z","timestamp":1633509894000},"page":"002-008","source":"Crossref","is-referenced-by-count":6,"title":["Allinside Anatomic Arthroscopic (3A) Reconstruction of Irreparable TFCC Tear"],"prefix":"10.1055","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5859-2438","authenticated-orcid":false,"given":"Andrea","family":"Atzei","sequence":"additional","affiliation":[{"name":"Pro-Mano, Hand Surgery and Rehabilitation, Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Andr\u00e9s","family":"Tandioy-Delgado","sequence":"additional","affiliation":[{"name":"Hand Surgery, Clinica las Am\u00e9ricas, Medellin, Antioquia, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-9655","authenticated-orcid":false,"given":"Lucian Lior","family":"Marcovici","sequence":"additional","affiliation":[{"name":"Hand & Microsurgery Unit, Jewish Hospital of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"Aust","sequence":"additional","affiliation":[{"name":"Arthrex GmbH, Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2918-9583","authenticated-orcid":false,"given":"Riccardo","family":"Luchetti","sequence":"additional","affiliation":[{"name":"Rimini Hand and Upper Limb Surgery & Rehabilitation Center, Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,10,5]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/0363-5023(89)90174-3","article-title":"Triangular fibrocartilage complex lesions: a classification","volume":"14","author":"A K Palmer","year":"1989","journal-title":"J Hand Surg Am"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.hcl.2011.05.014","article-title":"Foveal TFCC tear classification and treatment","volume":"27","author":"A Atzei","year":"2011","journal-title":"Hand Clin"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1053\/jhsu.2002.31731","article-title":"An anatomic reconstruction of the distal radioulnar ligaments for posttraumatic distal radioulnar joint instability","volume":"27","author":"B D Adams","year":"2002","journal-title":"J Hand Surg Am"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1177\/1753193409100120","article-title":"New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability","volume":"34","author":"A Atzei","year":"2009","journal-title":"J Hand Surg Eur Vol"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.injury.2013.01.009","article-title":"Arthroscopic reconstruction of triangular fibrocartilage complex (TFCC) with tendon graft for chronic DRUJ instability","volume":"44","author":"W L Tse","year":"2013","journal-title":"Injury"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1177\/1753193417690669","article-title":"Arthroscopic assisted tendon reconstruction for triangular fibrocartilage complex irreparable tears","volume":"42","author":"R Luchetti","year":"2017","journal-title":"J Hand Surg Eur Vol"},{"key":"ref7","first-page":"1","volume-title":"Arthroscopic wrist anatomy and setup","author":"N Badur","year":"2015"},{"key":"ref8","first-page":"187","volume-title":"L'articulation radio-cubitale inf\u00e9rieure. 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