scholarly journals Motion Analysis of Triangular Fibrocartilage Complex by Using Ultrasonography Images: Preliminary Analysis

Sensors ◽  
2022 ◽  
Vol 22 (1) ◽  
pp. 345
Author(s):  
Issei Shinohara ◽  
Atsuyuki Inui ◽  
Yutaka Mifune ◽  
Hanako Nishimoto ◽  
Kohei Yamaura ◽  
...  
Keyword(s):  
Motion Analysis ◽  
Triangular Fibrocartilage Complex ◽  
Control Group ◽  
Articular Disc ◽  
Ulnar Deviation ◽  
Radial Deviation ◽  
Velocity Magnitude ◽  
Injury Group ◽  
Triangular Fibrocartilage ◽  
The Mean

The triangular fibrocartilage complex (TFCC) is a significant stabilizer of the distal radioulnar joint. Diagnosing TFCC injury is currently difficult, but ultrasonography (US) has emerged as a low-cost, minimally invasive diagnostic tool. We aimed to quantitatively analyze TFCC by performing motion analysis by using US. Twelve healthy volunteers, comprising 24 wrists (control group), and 15 patients with TFCC Palmer type 1B injuries (injury group) participated. The US transducer was positioned between the ulnar styloid process and triquetrum and was tilted ulnarly 30° from the vertical line. The wrist was then actively moved from 10° of radial deviation to 20° of ulnar deviation in a 60-rounds-per-minute rhythm that was paced by a metronome. The articular disc displacement velocity magnitude was analyzed by using particle image velocimetry fluid measurement software. The mean area of the articular discs was larger on ulnar deviation in the control group. The mean articular disc area on radial deviation was larger in the injury group. The average articular disc velocity magnitude for the injury group was significantly higher than that for the control group. The results suggest that patients with TFCC injury lose articular disc cushioning and static stability, and subsequent abnormal motion can be analyzed by using US.

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.

Arthroscopic ligament-specific repair for triangular fibrocartilage complex foveal avulsions: a minimum 2-year follow-up study

2020 ◽  
pp. 175319342095790
Author(s):  
Bo Liu ◽  
Margareta Arianni ◽  
Feiran Wu
Keyword(s):  
Patient Reported Outcomes ◽  
Triangular Fibrocartilage Complex ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Flexion Extension ◽  
Patient Reported ◽  
Triangular Fibrocartilage ◽  
The Mean ◽  
Viable Method

This study reports the arthroscopic ligament-specific repair of the triangular fibrocartilage complex (TFCC) that anatomically restores both the volar and dorsal radioulnar ligaments into their individual foveal footprints. Twenty-five patients underwent arthroscopic ligament-specific repair with clinical and radiological diagnoses of TFCC foveal avulsions. The mean age was 28 years (range 14–47) and the mean follow-up was 31 months (range 24–47). Following arthroscopic assessment, 20 patients underwent double limb radioulnar ligament repairs and five had single limb repairs. At final follow-up, there were significant improvements in wrist flexion–extension, forearm pronation–supination and grip strength. There were also significant improvements in pain and patient-reported outcomes as assessed by the patient-rated wrist evaluation, Disabilities of the Arm, Shoulder and Hand score and modified Mayo wrist scores. Arthroscopic ligament-specific repair of the TFCC does not require specialist dedicated equipment or consumables and offers a viable method of treating these injuries. Level of evidence: IV

scholarly journals Atraumatic Bucket Handle Abnormality of the Triangular Fibrocartilage Complex in an Adolescent

2018 ◽  
Vol 08 (05) ◽  
pp. 423-425
Author(s):  
Leen Vanlaer ◽  
Sebastiaan Kellens ◽  
Maarten Van Nuffel
Keyword(s):  
Congenital Abnormalities ◽  
Incidental Finding ◽  
Anatomical Variations ◽  
Review Literature ◽  
Triangular Fibrocartilage Complex ◽  
Wrist Arthroscopy ◽  
Articular Disc ◽  
Traumatic Lesion ◽  
Triangular Fibrocartilage ◽  
Bucket Handle

Background Congenital abnormalities of the triangular fibrocartilage complex (TFCC) are rare and could be mistaken for a traumatic lesion. It is important to recognize these anatomical variations and to realize they do not always require treatment. Case Description An incidental finding of an atraumatic bucket handle abnormality of the TFCC in a 15-year-old male, who was treated arthroscopically for dorsal wrist pain. This structure was resected, thus obtaining a normal looking peripheral TFCC. Literature Review Literature regarding congenital abnormalities of the TFCC is limited to a meniscoid articular disc or a congenital perforation. To our knowledge, an atraumatic bucket handle abnormality has not been described yet. Clinical Relevance This congenital abnormality of the TFCC could be mistaken for a traumatic lesion on MRI, or during wrist arthroscopy; therefore, it is important to realize that this entity may occur and does not require treatment.

Acute blocking of forearm supination secondary to tearing of the triangular fibrocartilage complex

2020 ◽  
Vol 45 (9) ◽  
pp. 939-944
Author(s):  
Taku Suzuki ◽  
Toshiyasu Nakamura ◽  
Yoshihiko Tanino ◽  
Yukihiko Obara ◽  
Yasuhiro Yoshikawa ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Arthroscopic Surgery ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Minor Trauma ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Open Operation ◽  
Triangular Fibrocartilage ◽  
The Mean

We studied the characteristics of acute blocking of supination of the distal radioulnar joint caused by triangular fibrocartilage complex injuries. Twenty-four patients who were treated for acute blocking of supination were retrospectively assessed. Supination was suddenly blocked after minor trauma to the wrist. Active and passive supination was severely restricted with a mean preoperative range of motion (11°), whereas pronation was almost normal. The cause was identified arthroscopically or at open operation. It was found to be a result of avulsion of the dorsal or palmar portion of the radioulnar ligament, which blocked movement of the ulnar head. Blocking was reduced manually in four cases, by arthroscopic surgery in eight cases and by open surgery in 12 cases. After treatment, forearm supination improved to 84° of the mean range of motion. Distal radioulnar joint blocking from a ruptured triangular fibrocartilage complex should be considered in the differential diagnosis of loss of forearm supination. Level of evidence: IV

scholarly journals Congenital meniscoid articular disc of the triangular fibrocartilage complex

2009 ◽  
Vol 91-B (8) ◽  
pp. 1094-1096
Author(s):  
S.-J. Kim ◽  
H.-K. Moon ◽  
Y.-M. Chun ◽  
W.-H. Chang ◽  
S.-G. Kim ◽  
...  
Keyword(s):  
Triangular Fibrocartilage Complex ◽  
Articular Disc ◽  
Triangular Fibrocartilage

Morphology and Distribution of Nerve Endings in the Human Triangular Fibrocartilage Complex

1998 ◽  
Vol 23 (4) ◽  
pp. 522-525 ◽  
Author(s):  
M. OHMORI ◽  
H. AZUMA
Keyword(s):  
Collagen Fibre ◽  
Ulnar Collateral Ligament ◽  
Triangular Fibrocartilage Complex ◽  
Nerve Endings ◽  
Articular Disc ◽  
Collateral Ligament ◽  
Peripheral Part ◽  
Ulnar Side ◽  
Fibre Area ◽  
Triangular Fibrocartilage

We studied the morphology and distribution of nerve endings in the human triangular fibrocartilage complex using both silver staining and immunohistochemical staining using a protein specific to nerve fibres. Free nerve endings were found in the ulnar side of the triangular fibrocartilage complex, especially in the ulnar collateral ligament, meniscus homologue and the adjacent collagen fibre area of the peripheral part of the ulnar side of the articular disc. Meissner’s and Krause’s corpuscles were observed in the ulnar collateral ligament and meniscus homologue. The fact that free nerve endings were observed in the meniscus homologue and adjacent collagen fibre area of the peripheral part of the ulnar side of the articular disc suggests that this disc may be a source of wrist pain. The presence of nerve end bulbs in the triangular fibrocartilage complex also suggests a possible role for corpuscles as mechanoreceptors.

Reconstructed animation from four-phase grip MRI of the wrist with ulnar-sided pain

2013 ◽  
Vol 38 (7) ◽  
pp. 746-750 ◽  
Author(s):  
T. Oda ◽  
T. Wada ◽  
K. Iba ◽  
M. Aoki ◽  
M. Tamakawa ◽  
...  
Keyword(s):  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Wrist Pain ◽  
Articular Disc ◽  
Ulnar Head ◽  
Dynamic Variations ◽  
Ulnar Shortening Osteotomy ◽  
Shortening Osteotomy ◽  
Ulnar Wrist Pain ◽  
Triangular Fibrocartilage

In order to visualize dynamic variations related to ulnar-sided wrist pain, animation was reconstructed from T2* coronal-sectioned magnetic resonance imaging in each of the four phases of grip motion for nine wrists in patients with ulnar pain. Eight of the nine wrists showed a positive ulnar variance of less than 2 mm. Ulnocarpal impaction and triangular fibrocartilage complex injury were assessed on the basis of animation and arthroscopy, respectively. Animation revealed ulnocarpal impaction in four wrists. In one of the four wrists, the torn portion of the articular disc was impinged between the ulnar head and ulnar proximal side of the lunate. In another wrist, the ulnar head impacted the lunate directly through the defect in the articular disc that had previously been excised. An ulnar shortening osteotomy successfully relieved ulnar wrist pain in all four cases with both ulnocarpal impaction and Palmer’s Class II triangular fibrocartilage complex tears. This method demonstrated impairment of the articular disc and longitudinal instability of the distal radioulnar joint simultaneously and should be of value in investigating dynamic pathophysiology causing ulnar wrist pain.

scholarly journals The Diagnostic Value of the Ulnocarpal Stress Test for Differentiating the Symptomatic Triangular Fibrocartilage Complex Tear from the Incidental Tear

2020 ◽  
Vol 25 (4) ◽  
pp. 259-266
Author(s):  
Cheol-U Kim ◽  
Dong Hyun Kim ◽  
Bong Cheol Kwon
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Stress Test ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Triangular Fibrocartilage Complex ◽  
Diagnostic Process ◽  
Symptom Improvement ◽  
Control Group ◽  
Triangular Fibrocartilage

Purpose: The purpose of this study was to determine the diagnostic value of the ulnocarpal stress test (UCST) for differentiating the symptomatic triangular fibrocartilage complex (TFCC) tear from the incidental tear.Methods: From January 2013 to May 2020, a study was performed on 109 patients who underwent wrist arthroscopy and showed TFCC tear. Patients who had ulnar-sided wrist pain along with TFCC tear, and showed postoperative symptom improvement, and those with other lesions excluded were defined as symptomatic tear (experimental group) and the rest were defined as asymptomatic tear (control group). Diagnostic values of the UCST for differentiating the symptomatic TFCC tear from the incidental tear were calculated.Results: The UCST showed a sensitivity of 54%, a specificity of 95%, a positive predictive value of 98%, a negative predictive value of 31%, a positive likelihood ratio of 10.34, a negative likelihood ratio of 0.48, and an overall diagnostic accuracy of 61%. Conclusion: The UCST showed limited diagnostic value for symptomatic TFCC tear. Therefore, this test needs to be regarded as a part of diagnostic process and their results should be interpreted in the context of other relevant clinical information before reaching the diagnosis of symptomatic TFCC tear.

Triangular Fibrocartilage Complex (TFCC; Articular Disc) Tear

2010 ◽  
pp. 133
Author(s):  
Joel A. Vilensky ◽  
Edward C. Weber ◽  
Thomas E. Sarosi ◽  
Stephen W. Carmichael
Keyword(s):  
Triangular Fibrocartilage Complex ◽  
Articular Disc ◽  
Triangular Fibrocartilage
Sign in / Sign up

Export Citation Format

Share Document