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Dr. John Walker: This is John Walker with SportsMED Orthopedic Surgery and Spine
Center in Huntsville, Alabama. Today this video will show me performing
a debridement or a cleanup, if you will, of a triangular fibrocartilage complex tear.
This is also known as TFCC wrist surgery.
This is on a 53-year-old patient that presents with pain in the wrist.
This pain often is over what's called the ulnar side of the wrist.
It's often associated with popping, snapping in the wrist.
The video begins with the scope in the ulnar side of the wrist or looking ulnarly.
As we advance it into the wrist we see what appears to be a hole.
A probe was placed to feel the hole which actually are the edges of the triangular
fibrocartilage complex. The edges are very loose and unstable.
This is why most of the patients have the pain over that side of the wrist.
We typically insert some sort of device such, in this case, as a suction punch
and clean out or debride the edges of the cartilage and the excess tissue is then
sucked out through the punch.
The edges have been debrided with the punches and the biters we insert what's called a shaver.
This smooths out the edges of the cartilage.
It also sucks out any of the debris.
After all the edges have been debrided and shaved a final debridement is performed.
This catches any loose fragments that might be hanging on.
After the debridement is completed we insert a radio frequency deice that
essentially further smoothens the edges of the cartilage.
After debridement is complete, we insert a hook or a probe just to make sure the
edges are stable and that no other work needs to be done.
At this point the wrist scope is completed.
We've debrided the cartilage but in this case there was no evidence of a ligament
tear or rheumatoid arthritis.
This patient had no bone fragments and no bone spurs.
For more information on this type of surgery and other upper extremity
surgeries please visit our website at www.sportsmedalabama.com
Thank you.