Estudio biomecánico cadavérico de un método de reinserción foveal del complejo fibrocartílago triangular sin perforación foveal

Abstract

Triangular Fibrocartilage Complex (TFCC) injuries can lead to distal radioulnar joint (DRUJ) instability, particularly when affecting the foveal insertion, essential for maintaining joint stability. The literature has described multiple techniques for TFCC reattachment, including arthroscopic and open approaches, using various methods such as transosseous sutures through bone tunnels or anchors, without consensus on the optimal procedure. This biomechanical study evaluated the efficacy of a foveal reinsertion technique without foveal perforation, based on a modification of Mantovani's technique for Atzei's class 2 lesions. Twenty cryopreserved upper extremities were used (thirteen female and seven males, mean age 83 years). The experimental protocol systematically compared the radius displacement relative to the ulna in three conditions: intact TFCC, sectioned TFCC (simulating a class 2 foveal lesion), and TFCC repaired using the proposed technique. Measurements were performed in three forearm positions (neutral, 60° pronation, and 60° supination), applying a controlled 3 kg load in dorsal and volar directions to simulate functional stress. The FASTRAK® three-dimensional electromagnetic system allowed for high-precision displacement recordings. Results showed that TFCC sectioning significantly increased the displacement in all three positions, confirming the importance of the foveal insertion for joint stability. After repair using the proposed technique, displacement values decreased to levels comparable to those of the intact TFCC, with no statistically significant differences between both conditions. This technique offers significant advantages by preserving the TFCC's anatomical footprint, avoiding the creation of bone tunnels (reducing fracture risk and the need for radiological exposure), and distributing forces more uniformly across the insertion surface. Additionally, it does not require specific devices or complex instrumentation, making it more accessible and cost-effective. The research demonstrates that the developed technique effectively restores DRUJ stability to levels comparable to the intact TFCC in all three evaluated positions, constituting a viable and reproducible alternative for treating TFCC foveal lesions.

Date of Award	31 Oct 2025
Original language	Spanish
Awarding Institution	Universitat Autònoma de Barcelona (UAB)
Supervisor	Àngel Ferreres Claramunt (Director), Alfonso Rodriguez Baeza (Director) & Miguel Pérez Abad (Director)