Reconstruction of Triangular Fibrocartilage Complex Avulsions (Palmar 1C) with Associated Lunotriquetral and Dorsal Capsule Injury: A Case Report.

Case: A 34-year-old farmer and railroad worker injured his left wrist when working at a railroad. The resulting dorsal-ulnar wrist blow caused disabling pain. Splits and 2 subsequent surgeries failed, including an arthroscopic triangular fibrocartilage complex (TFCC) debridement and thermal ablation. Subsequently, magnetic resonance imaging documented a rare Palmer type 1C distal TFCC avulsion. Function was restored and return to farming permitted by reconstruction of the ulnotriquetral (UT) ligament using an extensor carpi ulnaris (ECU) slip.

Conclusion: Chronic Palmer type 1C TFCC injuries can be successfully treated with ECU reconstruction of the UT ligament.