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TFCC Lesion in Kendo Player

  • Toshiyasu NakamuraEmail author
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Abstract

Kendo is a unique martial arts developed in Japan, which represents ancient spirits of Japanese samurai. Instead of Japanese sword, bamboo sword (Shinai) is now used. Point is gained by effective hit to the head “men,” body “dou,” and hand-forearm “kote.” Due to repetitive stress applied on the wrist, lesions in the triangular fibrocartilage complex (TFCC) are popular in kendo players like other racket sports, such as tennis, golf, or baseball.

From 2001 to 2015, 13 kendo players underwent surgical treatment of TFCC injuries in our institute. There were 11 males and 2 females with an average age of 21 (range 15–48). Three right and ten left wrists were involved. Three patients were junior high school students, seven were high school students, one was a university student, and two were teachers. Obvious causes were unknown in all patients, while all claimed difficulties to play kendo due to ulnar-sided wrist pain. Diagnosis of TFCC injury was done by MRI and arthrogram and confirmed with wrist arthroscopy.

Arthroscopic exploration revealed that there were Palmer 1B tear in one wrist, complete rupture of the RUL at the fovea in seven, Palmer 2A tear in four, and 2C in one. Associated injuries were nonunion of the ulnar styloid in three, rupture of the extensor carpi ulnaris (ECU) tendon sheath floor in one, and complete rupture of the ECU tendon in one. Arthroscopic capsular repair was selected for 1B tear, open repair in five, arthroscopic transosseous repair in one, and reconstruction of the TFCC using an ECU half-slip tendon in one. Five degenerative TFCC injury cases and three positive ulnar variance cases were treated with ulnar shortening. For associated injuries, fixation of the ulnar styloid fragment was selected in one wrist, while in other two wrists, removal of the fragment was performed. Tendon sheath floor of the ECU was repaired, and tenodesis of the ECU tendon was selected in complete ruptured case. Clinical outcome obtained was 12 excellent and 1 good, all returned to original sports level.

Keywords

Kendo Triangular fibrocartilage complex (TFCC) Arthroscopy 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Research CenterInternational University of Health and WelfareTokyoJapan
  2. 2.Department of Orthopaedic Surgery, School of MedicineInternational University of Health and WelfareTokyoJapan

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