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  • Tfcc

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    Old 06-13-2016, 12:30 PM   #1
    BUD778
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    Tfcc

    Had the tfcc and radius shortening in Dec 2014. Still in pain from it, the tfcc feels the same prior to surgery. Been in and out of casts since, to help the pain, I also lost some rotation range in the arm. Dr wants to do serial casting to help improve rotation or do more surgery, any help would be great??
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    Radius Shortening/TFCC 12/14

     
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    Old 06-13-2016, 07:21 PM   #2
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    Re: Tfcc

    I had the same TFCC pain after surgery that I had before. I also had a significant loss of ROM and was far from being to supinate. Once I had my plate removed and some additional debridement, the pain resolved and I quickly regained my ROM to normal.

    There isn't a lot of room in the wrist area and from what I understand the plate causes more problems for some than others. The removal was a quick and easy surgery. No additional scar and I left with a wrap I was allowed to remove after 4 days. It took some PT to get back to normal since I had been dealing with problems for almost 2 years at that point, but the post plate-removal PT was so much better than the first post-surgical ones.

    Also, I ended up needing to seek another opinion. The one who removed the plate found a couple issues with my hand/wrist that my first hand ortho hadn't mentioned. He also noticed my plate had come a bit loose.
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    Last edited by MountainReader; 06-13-2016 at 07:28 PM.

     
    Old 06-14-2016, 06:35 AM   #3
    BUD778
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    Re: Tfcc

    How did they tell the plate was loose? I saw my dr this am. Wants to do mri again then possibly tfcc repair again and work on the contracture in the rotation. Why is the way I am not in pain is in a cast? Also being tested for EDS, meet with that dr Friday.
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    Tarsal Tunnell 11/2011
    Radius Shortening/TFCC 12/14

    Last edited by BUD778; 06-14-2016 at 06:37 AM.

     
    Old 06-14-2016, 04:53 PM   #4
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    Re: Tfcc

    Actually, a thorough physical assessment of the area identified the loose plate. When the second opinion doctor noticed it, he showed me where to feel and I could tell he was right.

    How are you being tested for EDS? With the Beighton or Brighton scales? Have they referred you to a geneticist?

    I have been told by my GI doc and 3 PT's who assessed me that I have hypermobility and probably EDS, but none are really willing to 'officially' diagnose me. They just treat me as if I have it. According to one PT, I score a 8/9 on the Beighton scale and meet 2 major criterias for EDS. Every year, it seems I add a new joint to my issues. I was never 'double jointed' or anything so this came as a surprise to me. Now that I know what isn't normal for some joints, I see the hypermobility.

    With the wrist, because the joints move around too much, it adds to the inflammation that is already there. That is part of why I think my osteotomy was so helpful.

    I really believe the plate in my wrist was physically contributing to my difficulty in regaining ROM. Once the plate was out, I regained the ROM so quickly. The challenge with hypermobility/EDS is learning what motions are normal and to work towards a typical normal in PT rather than my original normal which puts stress on the joint.

    I'm wondering if your plate is hitting wrong when you move and contributing to your pain.

    Another thing to consider with the TFCC pain is a Ulnotriquetral Ligament (UT) Split Tear. It was only discovered by a doctor at Mayo Clinic and published in 2008 and many doctors/surgeons aren't trained in it and don't look for it. Basically, the ligament splits lengthwise and falls open like a book. Because the ligament is attached to the bone on both ends, it doesn't show up on MRI's. When doctors are scoping you, evidently, it isn't easy to see unless they are looking for it. If you have EDS, the defective collagen makes ligaments more prone to injury and at times more difficult to heal. My second opinion doctor trained with the doctor who discovered it, which is why I sought him out after a lot of internet searching. He thought there was a high probability I had a UT split tear, but when he went in for the second surgery he found tons of debris and inflammation. Removal of the debris helped and I didn't need repair of the ligament.

    Also, I developed a good size cyst at the end of my plate that I had removed with the plate removal. Evidently, the cysts aren't uncommon with EDS and can develop with the synovial fluid leaks which was common with my wrist injuries. Either that, or it was from the plate rubbing. Anyway, I had a cyst removed from my other wrist a year later and realized how much they can impact the wrist depending on where they sit. You could see if that is a consideration for you too.
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