Arthrotomography of the wrist. The triangular fibrocartilage complex

Eighteen fresh cadaver wrists were radiographically studied using both arthrography and arthrotomography, to evaluate the results of the two techniques. With arthrography, communications between the distal radioulnar and radiocarpal joints were discovered in eight of the 18 wrists (44%). Although defects in the triangular fibrocartilage complex (TFCC) could be inferred from the arthrograms, the locations and dimensions of the defects could not be assessed satisfactorily. Using arthrotomography, three distinct patterns of TFCC defects were observed radiographically, which correlated with subsequent anatomic dissections of the cadaver specimens. Type I defects, located near the radial margin of the TFCC, are long, narrow posteroanterior fissures with thick regular borders that readily appose. Type II defects, located more centrally in the TFCC, are wide defects with thin irregular margins. Type III defects represent a communication between the prestyloid recess and the distal radioulnar joint. Arthrotomography of the wrist accurately delineates TFCC defects in cadaveric specimens and may become a valuable clinical radiographic procedure.