Joe A Shaw PA-C - 8/17/2008

Question
I have been dealing with wrist problems since a fall back in 9/2005.  It was treated as a sprain and after 1 1/2 years and 9 doctors, doctor number 10 found and repaired a TFCC tear in 12/2006.  I was recovering well, but it retore worse than the first time.  I had a second arthroscopic TFCC repair 10/2007.  I started having pain again about 9 months after that surgery.  I was casted for 4 weeks and that has not helped.  Now an open surgery has been recommended.  I am trying to figure out what the options might be to try and repair a third time or if it would even be worth it?  Is there a possibility of recovery this long after the initial tear?

Answer
Vickie,
I think you will need the surgery, but it just depends on how much pain and decreased function you have?...There is not going to be a set answer b/c there are so many variables w TFCC's and how they classify them. Palmer classifications class 1 (traumatic) A,B,C,D..Class 2(degenerative) A,B,C,D,E
It started out as traumatic but You probably have some degenerative changes now and scar tissue at the surgery site as well. I guess I would try and find a ortho hand specialist at a university or teaching hospital or if this is who you have already. With open surgery the should be able to tell whats going on a lot better and do more extensive repairs as needed. You could see if a ortho comes up in your town on orthofind on my site?