Instability of distal radio-ulnar joint (DRUJ) is caused by a foveal detachment of TFCC which is the primary stabilizer of this joint. A single tunnel technique footprint foveal repair with two resorbable threads is proposed, that has the advantage of one single tunnel, increase of refixation area, retentioning or repair of radio-ulnar ligaments.

The aim of this study is to present the results of a modified Chen's technique with the use of two threads instead of four in order to simplify the technique and reduce operating times, and compare them to the original technique.

We have treated 13 patients with this technique, mean age 41 yo (16–64), 8 males, 5 females, 8 cases dominant wrist. Patients were affected by foveal detachment of TFCC (Atzei class II or III) diagnosed under arthroscopy. Nine patients were evaluated with a mean follow up 9.5 months (6–14 months). Four patients operated recently are still under study. All patients had pre-operative pain and limitation of work and sports activities expecially under load. Pre-operatively all patients had ballottment test positive (mean 2,1/3), mean VAS was 7.25–0.9, mean Mayo 49.44–12, mean DASH 39.72–20.1, mean PRWE 62.7–23, mean grip 15 kg.

Data were compared to pre-operative evaluation. Mean Mayo score obtained was 92.5–6.45 (excellent), P<0.01, mean DASH 4.16–1.6, P<0.01, PRWE 9.9–8.2, P<0.01, mean VAS 0.75–0.9, P<0.01. All functional scores were statistically significant. Ballottment test was negative in all patients (0/3) compared to pre-op (P<0.01). Mean grip raised to 28 kg (P<0.08). Comparing the results of the original technique to the modified technique the results were similar. In fact Chen's results were: Mayo 95 (90–100) compared to modified technique 92–6.45; Chen's DASH 10 (9–15) compared to modified technique 4.16–1.6.

The advantage of this simplified technique are: the creation of a single ulnar tunnel, the use of a two resobable thread for the refixation of TFCC, no residual material in the joint, retensioning or repair of radio-ulnar ligaments in addition to refixation, reduction of operating time. From our preliminary results TFCC foveal refixation can be performed by modified Chen's technique with excellent results, similar to the original technique.

The preliminary results are excellent but a wider study with a longer follow-up is needed to give definitive results.