Clinical evaluation of a wrist sensorimotor rehabilitation program for triangular fibrocartilage complex injuries.

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Abstract

Conflict of interest statement: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. 5. Hand Surg Rehabil. 2023 Dec;42(6):492-498. doi: 10.1016/j.hansur.2023.07.009. Epub 2023 Jul 23. A structured non-operative treatment program for traumatic triangular fibrocartilage complex tear: A quasi-experimental study. Tse YL(1), Chau WW(2), Wong CW(2). Author information: (1)Sports Medicine and Rehabilitation Centre, CUHK Medical Centre, Hong Kong. Electronic address: tseyancy@gmail.com. (2)Department of Orthopaedics and Traumatology, the Chinese University of Hong Kong, Hong Kong. OBJECTIVES: Triangular fibrocartilage complex (TFCC) injury is a common cause of ulnar-sided wrist pain. However, treatment protocols vary across clinical settings and a standardized treatment protocol is needed to improve quality of care. We devised a rehabilitation regime which comprised both orthoses and exercises. We hypothesized that the program can effectively reduce pain and improve functional performance. MATERIALS AND METHODS: Thirty-two subjects participated in the 5-phase rehabilitation program. Progress was monitored every 3 weeks. Outcome measures comprised numeric pain rating scale (NPRS), activities of daily living (ADL) pain score, wrist range of motion (ROM), ADL performance score, patient-rated wrist evaluation (PRWE), power grip and distal radioulnar joint (DRUJ) instability grade. RESULTS: NPRS decreased from 5.3/10 to 0.5/10 while the ADL pain score improved from 10/20 to 19.1/20. ROM in flexion/extension and supination/pronation improved by 35%. Functional performance on ADL performance score and PRWE improved from 21/40 to 38/40 and 49.5/100 to 14.6/100, respectively. Power grip increased by 59.5%, and DRUJ stability improved. DISCUSSION: The combination of orthoses and progressive strengthening and proprioception training was effective in re-establishing DRUJ stability, and improving wrist strength and functional performance. CONCLUSIONS: This study provided insight for the development of a rehabilitation protocol for patients with TFCC injury. Copyright © 2023 SFCM. Published by Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.hansur.2023.07.009