Treatment of acute injuries of the triangular fibrocartilage complex associated with distal radioulnar joint instability.

One hundred thirty patients who had an injury of the triangular fibrocartilage complex (TFCC) with distal radioulnar joint (DRU) instability were treated operatively. The TFCC injury with DRUJ instability occurred as an isolated lesion in 20. After appropriate fracture stabilization, 86 patients were treated with closed reduction of the DRUJ and radioulnar transfixation with one to two Kirschner wires with the forearm in neutral rotation. In 19 patients the avulsed ulnar styloid was internally fixed, and the DRUJ supplemented with radioulnar transfixation. In 13 patients the ulnar styloid was internally fixed. In 12 patients with radial avulsion fractures the displaced bony fragment was percutaneously fixed with a Kirschner-wire. Postoperatively all the patients were immobilized in a long arm cast in neutral rotation for 6 weeks. The results were excellent in 95%, fair in 30, and poor in 5.