20231226 Wrist disorder p6 - Dr Leon

The following components are part of the TFCC except:

• Central articular disc

• Meniscal homologue

• ECU tendon

• Volar and dorsal radioulnar ligaments

• Ulnolunate and ulnotriquetral ligament origins

57 year-old-man fall on outstretch left hand while riding a bicycle. He complained of pain over the dorsal aspect of left wrist with pain on turning the doorknob or opening a bottle. Clinical examination reveals point tenderness distal to the ulnar head, ulnar to the FCU.

What is the gold standard investigation to diagnose his condition?

• Wrist Xray

• Wrist CT scan

• Wrist MRI

• Wrist Arthoscopy

• Wrist Arthrogram

40 year old fisherman had a history of trauma over his wrist 15 years ago and was treated conservatively. He now complains of pain and swelling, decreased grip strength, and stiffness over his right wrist. Clinical examination revealed tenderness over the DRUJ and pain on supination and pronation. The above is his xray. Patient opt for surgical intervention to alleviate his symptoms. Based on his history, examination and xray finding, what is the best surgical management for him?

• Adam-Berger TFCC reconstruction

• Sauve-kapandji procedure

• Darrach procedure

• Wrist arthroscopy and TFCC repair

• Wrist fusion

68-year-old retired pharmacist underwent a salvage procedure for the above condition 5 years ago.

He now complains of crepitus and pain over the wrist.

Which of the following would have been the likely cause of his pain.

• Heterotrophic ossification

• Radioulnar impaction syndrome

• Radiocarpal arthritis

• ECU tendinitis

• Kienbock Disease

35 year old male sustained a TFCC injury and underwent a wrist arthroscopy. The above is the arthroscopic result and it reveals a palmer 1A TFCC injury

What is the subsequent management for him.

• Arthroscopic repair

• Open repair

• Arthroscopic debridement

• TFCC reconstruction

• Sauve-kapandji procedure