Diagnostic coding and conservative treatment duration for traumatic triangular fibrocartilage complex tears: a crosssectional survey of the Korean Society for Surgery of the Hand

초록

Purpose: Triangular fibrocartilage complex (TFCC) injuries are clinically significant. However, standardized diagnostic coding and treatment guidelines remain lacking, particularly regarding the optimal duration of conservative management before surgery. This study investigated current practices among Korean hand surgeons concerning diagnostic coding and conservative treatment for traumatic TFCC tears.Methods: An online survey was distributed to 88 selected members of the Korean Society for Surgery of the Hand. The questionnaire addressed the selection of diagnostic codes for acute and chronic traumatic TFCC tears, and the recommended duration of conservative treatment. Multiple responses were permitted. Subgroup analyses considered clinical experience, hospital type, subspecialty certification, and board membership.Results: Sixty-two hand surgeons responded (70.4% response rate). For acute TFCC tears, 76.8% selected code S63.3 (traumatic rupture of ligament of wrist and carpus), and 53.8% recommended 3 months of conservative treatment. Coding was more variable for chronic TFCC tears, with increased use of M24.23 and unspecified codes. Subspecialists more consistently selected S63.3 for acute tears (p=0.040), but no significant subgroup differences were observed regarding treatment duration or chronic tear coding.Conclusion: Most Korean hand surgeons favored S63.3 for acute TFCC injuries and recommended a 3-month conservative treatment period. However, the variability in chronic coding and treatment practices suggests that TFCC-specific codes are necessary, as well as unified clinical guidelines to support standardized care and administrative accuracy.

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