The triangular fibrocartilage complex (TFCC): updated anatomy, variants, and MRI diagnostic pitfalls

Area of Science:

• Orthopedics
• Anatomy
• Radiology

Background:

• The triangular fibrocartilage complex (TFCC) is vital for ulnar wrist stability, connecting radioulnar and ulnocarpal joints.
• Recent arthroscopic anatomical studies propose a 3D, tripartite TFCC model.

Purpose of the Study:

• To provide a comprehensive understanding of the TFCC based on integrated arthroscopic, anatomical, biomechanical, and imaging data.
• To highlight the clinical implications of the updated TFCC conceptual framework for ulnar wrist injuries.

Main Methods:

• Review of arthroscopic anatomy, biomechanical principles, and advanced MRI techniques (3D isotropic sequences, MR arthrography).
• Integration of anatomical, functional, and imaging perspectives of the TFCC.

Main Results:

• The TFCC comprises articular disc, distal radioulnar ligaments, and a peripheral capsular structure.
• Vascularity is peripheral, impacting healing; distal radioulnar ligaments are primary stabilizers.
• MRI enables detailed TFCC visualization, tear detection, and differentiation of variants.

Conclusions:

• The updated tripartite TFCC model enhances understanding of ulnar wrist biomechanics and stability.
• Accurate TFCC assessment is crucial for clinical evaluation, surgical planning, and managing ulnar wrist injuries.