A New Arthroscopic Classification of Triangular Fibrocartilage Complex Disorders

Area of Science:

• Orthopedic Surgery
• Arthroscopy
• Wrist Anatomy

Background:

• Wrist arthroscopy is crucial for diagnosing and treating triangular fibrocartilage complex (TFCC) disorders.
• Existing arthroscopic classifications for TFCC lesions lack comprehensiveness and recent updates.

Purpose of the Study:

• To propose a novel, comprehensive arthroscopic classification for TFCC disorders.
• To base the classification on a recently described arthroscopic anatomy of the TFCC.

Main Methods:

• Incorporated existing TFCC disorders into an arthroscopic, functional, and vascular anatomical framework.
• Included patient-specific parameters like ulnar variance and distal radioulnar joint inclination.
• Considered tear chronicity (fresh/chronic) and reparability (reparable/nonreparable).

Main Results:

• Introduced the DRW classification: Disc (D - degenerative/traumatic), Reins (R - traumatic), Wall (W - traumatic).
• The classification allows for easy identification of isolated and combined TFCC lesions.
• Facilitates analysis of both degenerative and traumatic TFCC disorders.

Conclusions:

• The proposed DRW classification offers an updated, three-dimensional, three-part arthroscopic description of TFCC disorders.
• This classification is relevant for understanding etiology and guiding treatment principles for TFCC injuries.