Disclosures: Angie J. Lastra, MD: No financial relationships or conflicts of interest

Case Diagnosis: Young veteran male with chronic ulnar sided wrist pain after golfing injury secondary to triangular fibrocartilage complex tear managed successfully with ultrasound-guided leukocyte poor platelet rich plasma injection therapy.

Case Description or Program Description: 36 yo right-handed veteran male with chronic right ulnar-sided wrist pain attributed to golfing injury. Pain at 8/10 with activity and associated with decreased grip strength. Pain was refractory to conservative management and was interfering with patient’s ability to train for the US Marshall Services. Exam consistent with foveal and extensor carpi ulnaris tenderness. Wrist MRI showed a central and peripheral TFCC tear. Orthopedic surgery recommended PRP Injection prior to surgery.

Setting: Outpatient Clinic

Assessment/Results: PRP protocol was followed and 1.5 cc of LP-PRP was injected into TFCC under ultrasound-guidance with no complications. At 3 month follow up patient reported 50% pain relief and a second PRP injection was done. At 7 month follow up, reported 70% pain relief associated with unremarkable exam. At 9 months, reported “no pain”, remarkable satisfaction and no activity restrictions including application to US Marshall Services.

Discussion (relevance): TFCC is an anatomical entity located on the ulnar aspect of the wrist joint that acts as main stabilizer and is vulnerable to injury. PRP has the potential to augment repair of tissues with low healing ability, such as with TFCC. Our patient with TFCC tear, displayed completed pain resolution after two rounds of PRP injections with no complications. This case demonstrates the role of PRP as a therapeutic option for the management of TFCC tears prior to surgical consideration.

Conclusions: This case illustrates a case of a young veteran patient with chronic ulnar sided wrist pain secondary to traumatic TFCC tear that was managed successfully with two rounds of PRP injection therapy at 3-month intervals. This is a safe alternative and along with occupational therapy may provide long-term solution for these patients.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/successful-use-of-leukocyte-poor-platelet-rich-plasma-for-the-management-of-triangular-fibrocartilage-complex-tear-in-a-young-male-veteran-a-case-report/