Full Length Article| Volume 36, ISSUE 1, P179-195, January 2023

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Wrist and forearm range of motion commencement time following primary triangular fibrocartilage complex foveal repair surgery: A scoping review

Published:December 29, 2021DOI:


      • TFCC rehabilitation following foveal repair surgery was inconsistently reported.
      • TFCC rehabilitation protocols varied between the included studies.
      • Adverse events were rarely reported to have occurred.
      • No study provided any supporting literature to justify rehabilitation recommendations.


      Study Design

      Scoping review.


      Rehabilitation guidelines following triangular fibrocartilage complex (TFCC) foveal repair surgery have been inconsistently reported in the published literature, with no consensus regarding wrist or forearm range of motion (ROM) commencement time.

      Purpose of the Study

      To scope the available literature to identify the extent and strength of the evidence supporting the clinical guidelines for wrist and forearm ROM commencement time following primary TFCC foveal repair surgery.


      A systematic search produced 26 studies (3 retrospective cohort studies, 1 prospective cohort study, 1 retrospective comparative study, and 21 retrospective case series) that described specific rehabilitation protocols following TFCC foveal repair surgery.


      No supporting evidence was identified regarding rehabilitation protocol recommendations across all the included studies. Postsurgery wrist ROM commencement ranged from 2 to 8 weeks; forearm ROM commencement ranged from 2 to 12 weeks. ROM commencement times did not appear to systematically influence the rate of adverse events, although adverse events were poorly reported.


      TFCC rehabilitation protocols were poorly reported and varied widely between the included studies. Additional research is recommended to comprehensively evaluate the association between wrist and/or forearm ROM and the rate of adverse events for this complex and multifaceted condition.


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      JHT Read for Credit

      Quiz: # 913

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1.
        The timing of the initiation of ROM exercises
        • a.
          was not discussed
        • b.
          was systematically the same for wrist flex-extend exercises as supination-pronation exercises
        • c.
          had a very predictable relationship to the development of adverse events
        • d.
          did not appear to have much bearing on the frequency of adverse events
      • # 2.
        The authors
        • a.
          searched patient charts for evidence
        • b.
          surveyed CHTs for expert opinions
        • c.
          searched the literature for evidence
        • d.
          interviewed surgeons for expert opinions
      • # 3.
        Post surgery ROM exercises were
        • a.
          not initiated at a consistent time from study to study
        • b.
          initiated at approximately the same time from study to study
        • c.
          delayed until 2 months post-op
        • d.
          initiated at approximately 2 days post-op
      • # 4.
        The investigators
        • a.
          were able to identify a significant correlation between the timing of the initiation of exercises and outcomes
        • b.
          could discern no meaningful relationship between the timing of the initiation of exercises and outcomes
        • c.
          placed more emphasis on the effect of wrist flex-extend exercises than on supination-pronation exercises
        • d.
          place more emphasis on supination-pronation exercises than on wrist flex-extend exercises
      • # 5.
        Post-op protocols were not well reported
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.