Highlights
- •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.
Abstract
Study Design
Scoping review.
Background
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.
Methods
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.
Results
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.
Conclusions
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.
Keywords
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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 JHTReadforCredit.com. 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
- a.
- # 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
- a.
- # 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
- a.
- # 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
- a.
- # 5.Post-op protocols were not well reported
- a.false
- b.true
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: December 29, 2021
Accepted:
October 2,
2021
Received in revised form:
August 8,
2021
Received:
February 17,
2021
Footnotes
Financial disclosure statement: None of the authors have a financial interest in the completion of this scoping review.
Competing or conflict of interest statement: This scoping review was conducted by the corresponding author as part of a higher degree by research under supervision from the listed co-authors. None of the authors have any additional conflict of interests to declare.
Identification
Copyright
Crown Copyright © 2021 Published by Elsevier Inc. All rights reserved.
