Wear Patterns of the Articular Cartilage and Triangular Fibrocartilaginous Complex of the Wrist: A Cadaveric Study

The incidence and patterns of degenerative changes within the radio-carpal joint were studied in 138 specimens of elderly cadaveric wrists. Articular cartilage wear of varying severity was seen on the distal radial and ulnar articular surfaces in 27% of cases and on the proximal row articular surfaces in 54%. Wear was most commonly seen on the radial styloid and corresponding area of the scaphoid. The triangular fibrocartilaginous complex (TFCC) was found to be degenerate or torn in 24%. Central degenerative perforation was commonly associated with articular cartilage wear on the ulnar head and the ulnar half of the lunate. No significant wear pattern was seen in those wrists with peripheral linear (i.e. traumatic) TFCC tears. Interosseous scapho-lunate and luno-triquetral ligament disruptions were found in less than 10%, suggesting that disruption of these ligaments is usually traumatic and not degenerative.

The Gymnast’s Wrist: Acquired Positive Ulnar Variance Following Chronic Epiphyseal Injury

Five cases of symptomatic acquired positive ulnar variance are described. All cases occurred due to premature physeal closure of the growth plate in teenage girl gymnasts. All cases demonstrated ulno-carpal impingement, for which we describe a clinical test. Arthroscopic assessment of the wrist allowed us to assess the integrity of the TFCC (triangular fibrocartilaginous complex) and decide on the most appropriate surgery. Two patients needed distal ulna recession and one needed shaving for a TFCC perforation, with a good result.