J Wrist Surg 2021; 10(04): 286-289
DOI: 10.1055/s-0041-1723795
Scientific Article

Effectiveness and Safety of Triangular Fibrocartilage Complex Injection Regarding Anatomical Landmarks: A Cadaveric Study

Hamid Namazi
1   Department of Orthopedic Surgery, Bone and Joint Diseases Research Center, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
,
Amir Ghane
1   Department of Orthopedic Surgery, Bone and Joint Diseases Research Center, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
,
Amir Reza Dehghanian
2   Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
,
Mehran Fereidooni
3   Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
,
Armin Akbarzadeh
1   Department of Orthopedic Surgery, Bone and Joint Diseases Research Center, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
› Author Affiliations
Funding The project was financially supported by Shiraz University of Medical Sciences.

Abstract

Background Triangular fibrocartilage complex (TFCC) injections can be applied using anatomical landmarks or under the guide of ultrasound (US). US is not always available, and the physician may rely on the anatomical landmarks.

Objective The study aims to evaluate the effectiveness and safety of TFCC injection with anatomic landmarks.

Methods Forty wrist specimens from cadavers were randomly assigned to four rapid blue stain injection groups as follows: Group A: perpendicular to skin with 5 mm depth; Group B: perpendicular to skin with 10 mm depth; Group C: 45-degree angulation to skin surface, oriented from proximal to distal with 10 mm depth; and Group D: 45-degree angulation to skin surface, oriented from distal to proximal with 10 mm depth. TFCC specimens were excised and evaluated with microscopy, and adjacent neurovascular structures were checked for any injury.

Results Injections in group A were more accurate than others, in which 8/10 injections were successful. Group C injections were least accurate in that only 4/10 were successful. The other remaining groups (groups B and D) revealed similar results (5/10 were successful). However, statistical analyses did not show any significant difference (p-value = 0.35). No injury to neurovascular structures was seen.

Conclusion Needle placement perpendicular to skin with 5 mm depth and just medial to ulnar styloid can be used as an accurate method of palpation-guided technique for TFCC injections.



Publication History

Received: 22 September 2020

Accepted: 29 December 2020

Article published online:
09 February 2021

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