Management of failed TFCC repairs

Despite appropriate management of distal radius fractures, TFCC tears and DRUJ instability in the acute setting, a subset of patients will have ongoing pain or instability of the DRUJ. Ongoing instability is thought to eventually lead to pain, loss of motion and degenerative changes due to alterations in normal kinematics of the joint, although there is little in the literature to support this hypothesis. With an ever increasing emphasis on evidence based medicine, the treatment of asymptomatic instability is therefore difficult to justify as there are no long term natural history studies to document the definitive progression to clinical problems. The symptomatic patient however presents a different situation entirely. Stability of the DRUJ is conveyed by both static and dynamic influences.