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Traumatic disruption of the triangular fibrocartilage complex. Pathoanatomy
1New York University Medical Center, New York.
Clinical Orthopaedics and Related Research
|February 11, 1992
Summary
Traumatic triangular fibrocartilage complex (TFCC) disruption often causes ulnar wrist instability due to articular disk detachment. Many injuries involve multiple wrist structures, but these complex lesions are often repairable.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Sports Medicine
Background:
- Traumatic disruptions of the triangular fibrocartilage complex (TFCC) are a common cause of ulnar wrist pain and instability.
- Understanding the spectrum of TFCC injuries is crucial for effective surgical management.
Purpose of the Study:
- To classify the surgical pathology of traumatic TFCC disruptions.
- To identify the primary causes of distal radioulnar joint instability in TFCC injuries.
- To determine the suitability of complex TFCC lesions for surgical repair.
Main Methods:
- Surgical pathology analysis of 42 cases of traumatic TFCC disruption.
- Classification of injuries into five stages of increasing ulnar wrist instability.
- Evaluation of concomitant injuries to adjacent wrist structures.
Main Results:
- Detachment of the articular disk from its ulnar insertion was the primary cause of instability in all cases.
- 67% of cases involved additional injuries to the extensor carpi ulnaris sheath, ulnocarpal ligaments, or peritriquetral ligaments.
- Peripheral disk disruption was often the main component of multicomponent lesions, which were suitable for repair.
Conclusions:
- Surgical pathology of traumatic TFCC disruption presents a spectrum of injury.
- Distal radioulnar joint instability is mainly caused by articular disk detachment.
- Successful surgical outcomes depend on recognizing whether injuries affect the disk selectively or involve wider wrist anatomy.