Update TFCC: histology and pathology, classification, examination and diagnostics.

Area of Science:

• Orthopedics
• Hand Surgery
• Anatomy

Background:

• The triangular fibrocartilage complex (TFCC) is vital for distal radioulnar joint (DRUJ) stability and complex hand movements.
• Its structure, including the articular disc, plays a critical role in pronation and supination.
• Age-related degeneration of the TFCC is common, impacting hand function.

Purpose of the Study:

• To review the anatomy, function, and pathologies of the TFCC.
• To discuss diagnostic methods for TFCC lesions.
• To highlight the importance of clinical examination and current diagnostic standards.

Main Methods:

• Review of anatomical and clinical literature on the TFCC.
• Discussion of classification systems for TFCC lesions (Palmer, Atzei).
• Evaluation of diagnostic modalities including clinical examination, arthroscopy, and MR arthrography.

Main Results:

• The TFCC's superficial and deep fibers are crucial for pronation/supination.
• The articular disc, though centrally avascular, shows potential for regeneration.
• Clinical examination is essential for symptom localization, with wrist arthroscopy as the gold standard for diagnosis.

Conclusions:

• A functional TFCC is indispensable for hand function.
• Complementary classification systems aid in understanding TFCC lesions.
• While arthroscopy is the gold standard, MR arthrography shows promise as a future diagnostic alternative.