Origins and Insertions of the Triangular Fibrocartilage Complex: A Histological Study

2001 ◽  
Vol 26 (5) ◽  
pp. 446-454 ◽  
Author(s):  
T. NAKAMURA ◽  
S. TAKAYAMA ◽  
Y. HORIUCHI ◽  
Y. YABE
Keyword(s):  
Hyaline Cartilage ◽  
Histological Study ◽  
Dorsal Side ◽  
Triangular Fibrocartilage Complex ◽  
Ulnar Styloid ◽  
Broad Area ◽  
Central Transition ◽  
Fresh Frozen ◽  
Triangular Fibrocartilage ◽  
Narrow Area

The origins and insertions of the triangular fibrocartilage complex (TFCC) were examined histologically in serially sectioned fresh-frozen cadaver wrists. The radioulnar ligament arose vertically through Sharpey’s fibres from a broad area in the ulnar fovea and more horizontally from a narrow area at the base of the ulnar styloid. The floor of the extensor carpi ulnaris sheath also originated firmly from the dorsal side of the fovea of the ulna, through an arrangement of Sharpey’s fibres. Loose ulnocarpally oriented fibres, corresponding to a thickened ulnar joint capsule, arose from the hyaline-like cartilage matrix at the tip of the ulnar styloid and inserted onto the triquetrum without Sharpey’s fibres. The ulnolunate and ulnotriquetral ligaments originated not from the ulna, but from the palmar side of the TFCC. The insertion of the TFCC into the sigmoid notch of the radius demonstrated a central transition from the fibrocartilaginous disc into hyaline cartilage and a firmer fibroosseous transition of the dorsal and palmar portions of the radioulnar ligament at the periphery.

scholarly journals Cine MRI of the Triangular Fibrocartilage Complex during Radial–Ulnar Deviation

2018 ◽  
Vol 07 (04) ◽  
pp. 274-280 ◽  
Author(s):  
Koji Abe ◽  
Nobuki Terada ◽  
Toshiyasu Nakamura
Keyword(s):  
Healthy Volunteers ◽  
Stress Test ◽  
Styloid Process ◽  
Distal Portion ◽  
Triangular Fibrocartilage Complex ◽  
Cine Mri ◽  
Ulnar Styloid ◽  
Ulnar Deviation ◽  
Radial Deviation ◽  
Triangular Fibrocartilage

Purpose Changes in the shape of the triangular fibrocartilage complex (TFCC) during radial–ulnar deviation were studied using “cine-mode” magnetic resonance imaging (MRI) in 10 right wrists of healthy volunteers, 5 wrists of TFCC tear, and 5 wrists of ulnar styloid nonunion. Subjects and Methods The wrist was fixed in a custom acrylic device, which only allows radial and ulnar deviation. Coronal MR images of nine radial–ulnar deviated positions (every 5 degree from 15 degrees radial deviation to 25 degrees ulnar deviation) were obtained in volunteers and patients. Cine-mode MRI was assembled and was output to MPEG video to observe. Results Cine MRI demonstrated the ulnar side of the TFCC was elongated by average 15 mm in 15 degrees of radial deviation and shortened by average 8 mm in 25 degrees of ulnar deviation in all normal TFCC subjects. Distal portion of the triangular fibrocartilage (TFC) was compressed during radial–ulnar deviation in 10 healthy volunteers and in 3 patients, but proximal portion of the TFC was stable throughout the motion. In contrast, the wavy deformities on the disc in ulnar deviation were observed in three patients with horizontal tear inside the TFCC. In nonunion of the ulnar styloid process, the fragment was snapped in maximum ulnar deviated position or elongation of the space between the styloid fragment and ulna was seen. Conclusion This study indicated normal and abnormal changes in the shape of the TFCC during radial–ulnar deviation motion on cine MRI. The abnormal dynamic changes of the TFCC may be seen in ulnar deviated position in patients, which are related to positive ulnocarpal stress test with the wrist forced ulnar deviated.

Extensor Carpi Ulnaris Problems at the Wrist–Classification, Surgical Treatment and Results

2005 ◽  
Vol 30 (3) ◽  
pp. 265-272 ◽  
Author(s):  
C. ALLENDE ◽  
D. LE VIET
Keyword(s):  
Surgical Treatment ◽  
Grip Strength ◽  
Triangular Fibrocartilage Complex ◽  
Ulnar Styloid ◽  
Wrist Motion ◽  
Extensor Carpi Ulnaris ◽  
Lunotriquetral Ligament ◽  
Triangular Fibrocartilage

Twenty-eight extensor carpi ulnaris lesions at the wrist were treated surgically between 1990 and 2002. Fifteen patients had an isolated extensor carpi ulnaris tenosynovitis or tendinopathy, five had extensor carpi ulnaris dislocation, four had an extensor carpi ulnaris subluxation and four had an extensor carpi ulnaris rupture. Seventeen patients first developed their symptoms while playing sports. At a mean follow-up of 23 months, twenty-two patients had returned to their previous activities. Seven of the 27 patients had lost more than 30% of their grip strength and five had restricted wrist motion. Two needed an extensor carpi ulnaris tenolysis. Pure isolated extensor carpi ulnaris lesions are rare and associated ulnar sided lesions (eleven triangular fibrocartilage complex tears and four lunotriquetral ligament tears), as well as possible predisposing factors (seven anomalous tendon slips, four ulnar styloid non-unions and one flat extensor carpi ulnaris tendon groove), were frequent. A classification of extensor carpi ulnaris tendon and subsheath lesions was developed to allow the surgeon to adequately evaluate the different components of these lesions.

scholarly journals Triangular Fibrocartilage Complex Injury in Professional Cricketers

2015 ◽  
Vol 49 (4) ◽  
pp. 204-208
Author(s):  
Usama Talib ◽  
Sohail Saleem
Keyword(s):  
Sports Injury ◽  
Triangular Fibrocartilage Complex ◽  
Wrist Injury ◽  
Huge Number ◽  
Ulnar Styloid ◽  
Tennis Players ◽  
Ulnar Side ◽  
Complex Injury ◽  
Triangular Fibrocartilage

ABSTRACT Triangular fibrocartilage complex (TFCC) is a complex of multiple ligaments and cartilages at the ulnar end of the wrist. Injury of TFCC is commonly seen in sportsmen such as tennis players, cricketers, golfers and gymnasts. The typical presentation is pain radiating along the ulnar side of the hand, and is often accompanied by fracture of the ulnar styloid. Despite being a common injury, its knowledge remains largely unknown. This leads to a huge number of cases remaining undiagnosed and thus untreated and unreported. The authors report a TFCC injury in a professional Cricketer in an attempt to create awareness of this common sports injury. How to cite this article Talib U, Saleem S. Triangular Fibrocartilage Complex Injury in Professional Cricketers. J Postgrad Med Edu Res 2015;49(4):204-208.

scholarly journals Osteoid Osteoma Mimicking Triangular Fibrocartilage Complex Injury: Diagnosis and Review of Treatment

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
J. M. Lamo-Espinosa ◽  
A. González ◽  
S. Amillo
Keyword(s):  
Osteoid Osteoma ◽  
Articular Surface ◽  
Treatment Algorithm ◽  
Triangular Fibrocartilage Complex ◽  
Review Of The Literature ◽  
Ulnar Styloid ◽  
The Real ◽  
Complex Injury ◽  
Special Behaviour ◽  
Triangular Fibrocartilage

We report the case of osteoid osteoma (OO) with ulnar styloid involvement. A review of the literature has been made with the aim of defining the special behaviour of OO when it is near the articular surface. That behaviour can affect the diagnosis, masking the real etiology of the pain, delaying the diagnosis, missing the diagnosis, or what is more serious, conducting an inadequate treatment. We propose a treatment algorithm conducted based on the localization near or far from articular surface and the superficial or deep localization.

VARIOUS PATTERNS OF TRAUMATIC TRIANGULAR FIBROCARTILAGE COMPLEX TEAR

Hand Surgery ◽  
2012 ◽  
Vol 17 (02) ◽  
pp. 191-198 ◽  
Author(s):  
Y. Abe ◽  
Y. Tominaga ◽  
K. Yoshida
Keyword(s):  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Wrist Arthroscopy ◽  
New Classification ◽  
Ulnar Styloid ◽  
Ligament Tear ◽  
Radioulnar Joint ◽  
Horizontal Tear ◽  
Radial Tear ◽  
Triangular Fibrocartilage

We demonstrate various patterns of traumatic triangular fibrocartilage complex (TFCC) tears including some atypical that cannot be categorized under Palmer's classification. TFCC traumatic tears in 173 wrists were examined arthroscopically or macroscopically and divided into disk tears (subdivided into four types: slit tear, flap tear, horizontal tear and tear within the distal radioulnar joint) and peripheral tears (subdivided into six types: ulnocarpal ligament tear, dorsal tear, radial tear, ulnar styloid tear, foveal tear and distal radioulnar ligament tear). Combinations of these types were found in 32 wrists. Wrist arthroscopy revealed various traumatic TFCC tears that do not come under Palmer's classification; therefore establishment of a new classification for traumatic TFCC tears seems to be warranted.

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