SEARCH · PubMed Health

Results for “Triangular Fibrocartilage”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources

PubMed1994

Ulnar variance: facts and fiction review article.

The relative length of the ulna compared to the radius, or ulnar variance, appears to be an important element in wrist pathology. The length is determined by age, genetic factors, load (i.e. gymnasts) and gross elbow pathology. The negative ulnar variance or short ulna has been associated with Kienböck's disease, avascular necrosis of the scaphoid and scapholunate dissociations. This could not be confirmed in our observations. On the contrary, a long ulna (positive ulnar variance) is harmful for the ulnar compartment of the wrist as it causes degeneration and perforation of the triangular fibrocartilage complex (TFCC) and cartilaginous wear of the carpal bones (ulnar impaction syndrome). The ulnar variance is also determinant for the morphology of the sigmoid notch of the radius. With wrist arthroscopy a more precise diagnosis of ulnar wrist pain has become possible.

Age Factors↗

PubMed1993

The interosseous membrane of the forearm: structure and its role in Galeazzi fractures.

A cadaveric study was performed to anatomically describe and mechanically document the interosseous membrane of the forearm using gross, histologic, scanning electron microscopic, and mechanical testing. The membrane was found to be a complex structure composed of nerves and vessels but mainly of collagen fibers that thicken to form bands coursing from radius to ulna. Strain-gauge studies demonstrated that the load transfer occurs from the radius to the ulna via the membrane and changes with supination or pronation. With specimens under a specific test load, sectioning of the membrane allowed the fractured radius to shorten by 6.25 mm and sectioning of the triangular fibrocartilage complex resulted in shortening of 7.7 mm. Total shortening after osteotomy and sectioning of the complex structure and membrane ranged from 15 to 40 mm. In Galeazzi fractures, the interosseous membrane acts as a constraint to radial shortening. Anatomic reduction with internal fixation is indicated for this fracture-dislocation.

Aged↗

PubMed1993

Ligamentous anatomy of the medial carpal region.

The purpose of this study is to elucidate the ligamentous anatomy of the medial carpus in order to characterize the pathologic basis of pisiform subluxation secondary to traumatic ligament rupture. Medial carpal ligamentous anatomy has been studied in the past by anatomic dissection and analyzed in terms of comparative morphology. A review of this literature reveals that the anatomy of the region requires further definition. We have performed cadaveric dissections that reveal that the ulnar or medial carpal ligament complex is composed of three structures: (1) the triangular fibrocartilage, (2) the meniscus homologue, and (3) the ulnar collateral ligament. We conclude that the medial carpal ligament complex has an insertion into the pisiform bone.

Aged↗

PubMed1993

[Roentgenographical and anatomical study of the midcarpal joint--morphology and degenerative change of ulnar side].

The present investigator has studied the following anatomic variations and degenerative changes of the articular cartilage of the ulnar side of the midcarpal joint: the perforation of the triangular fibrocartilage (TFC), and the ruptures of the scapholunate and lunotriquetral interosseous ligaments (S-L lig., L-T lig.). The materials were 127 wrist joints obtained from 66 cadavers (age 32-95, average age 74) and were studied radiographically and anatomically. Two types of the ulnar side of the midcarpal joint were classified radiographically and anatomically. In the first type, there was no articulation present between the hamate and the lunate in 42.5% of the dissected specimens. In the second type, there was an articulation present between the hamate and the lunate in 57.5% of the dissected specimens. Wrists of the second type correlated significantly with the ulnar shift ratio of lunate on the radiographical measurement (p < 0.01). Significant cartilage erosion and exposed subchondral bone were found at the joints of the second type. There was no correlation between the TFC perforation, the carpal interosseous ligament ruptures and degenerative changes of the articular cartilage of the ulnar side of the midcarpal joint.

Adult↗

PubMed1993

Distal radioulnar joint function after Galeazzi fracture-dislocations treated by open reduction and internal plate fixation.

Nineteen Galeazzi fracture-dislocations were reviewed clinically and roentgenographically at an average of 83 months after open reduction and internal fixation. Radiographic observation of fracture reduction was correlated with clinical results. Patients with anatomic fracture reduction had minimal sequelae and better or equal functional results than patients with imperfect reduction. Manual laborers had no weakness, but nonmanual laborers showed significant deficits in supination strength. Concomitant fractures of the wrist, the hand, or both were associated with significant pronation weakness. The volar approach was associated with a significant deficit of flexion/extension range of motion (ROM). Attention was focused on distal radioulnar joint (DRUJ) function and pain. Distal radioulnar joint function was fully restored by open reduction and internal fixation of the radius and indirect anatomic reduction and functional aftercare of the DRUJ in 16 cases. Open revision, repair of the triangular fibrocartilage complex (TFCC), and immobilization of the wrist are not necessary if anatomic reduction of the joint is obtained by indirect means such as open reduction and internal fixation of the radius.

Adult↗

PubMed1993

[Trispiral tomography and magnetic resonance imaging of the wrist joint].

Tomography and magnetic resonance imaging (MRI) are important imaging techniques in the diagnosis and management of a wide variety of wrist disorders. They have been useful for evaluating fractures, tumors, arthritic conditions and avascular necrosis involving the carpal bones as well as injuries affecting the radiocarpal and intercarpal ligaments and the triangular fibrocartilage complex. The indications and clinical applications of each imaging technique will be discussed.

Adult↗

PubMed1993

[The painful ulno-carpal joint. Diagnosis and therapy].

The ulnocarpal joint plays a critical role in hand and wrist function. It serves as part of forearm rotation as well as part of the carpal kinematics. The joint is comprised of the distal radio-ulnar articulation, triangular fibrocartilage complex, lunate, triquetrum, hamate, and pisiform, and the intra and extracapsular ligamentous and soft tissue constraints. Traumatic disruptions as well as chronic inflammatory conditions are commonplace. In addition to standard radiographs, arthrography, CT scanning, and MRI studies prove useful. Wrist arthroscopy is becoming of increasing importance in this region of the wrist. Ulnar impaction syndrome may occur associated with malunion of distal radius fracture, ulna positive variance, or chronic TFCC tears. Osteotomy of the distal radius or ulnar shortening osteotomy should be considered. Instability of the distal ulna can be treated with tenodesis procedures, hemi-resection arthroplasty, matched ulna resection or the Sauvé-Kapandji procedure.

Biomechanical Phenomena↗

PubMed1993

Wrist arthrography.

The ligaments of the proximal row of carpal bones and the triangular fibrocartilage (TFC) strongly influence the function and stability of the wrist. Injury to the ligaments may result in chronic wrist pain or instability. Wrist arthrography is valuable in the investigation of such damage when surgical intervention is considered and plain radiography is unrewarding. There are also several technical modifications of the standard radiocarpal arthrography available. Owing to the possibility of congenital perforations and degenerative changes in these ligaments the arthrographic findings should be related to the clinical signs and the age of the patient. CT has less diagnostic importance in this respect while MR imaging is an alternative and may become the method of choice. Both these methods have great potential in the evaluation of soft tissues of the wrist other than the TFC.

Arthrography↗

PubMed1993

Imaging techniques for distal radius fractures and related injuries.

In patients with distal radius fractures, routine roentgenographic examination in at least two or three planes should be performed first and is usually sufficient for correct diagnosis and adequate treatment. A careful examination of the soft tissues of the forearm and wrist on conventional roentgenograms may be key for correct diagnoses. Routine roentgenographic examination of the wrist, preferable in four views, should be performed in every patient with a distal radius fracture acutely as well as at follow-up. The technique is easy to perform, universally available, and inexpensive. Advanced imaging techniques such as radionuclide bone imaging, CT, or MR imaging should not be first choice modalities in patients with distal radius fractures and should be used only when conventional roentgenograms are inconclusive. Scintigraphy can be helpful for diagnosing occult fractures, for documenting fracture healing and ligamentous or cartilaginous post-traumatic disorders, as well as for diagnosis and follow-up of reflex sympathetic dystrophy. A disadvantage of scintigraphy is its poor specificity. Indications for CT include the confirmation of occult fractures suspected on the basis of the findings of physical examination and focally hot bone scintigrams when plain films are normal or inconclusive. In comparison with conventional radiography, CT is superior for the preoperative evaluation of complex comminuted distal radius fractures, depicting the distal radial articular surface and size and position of fracture fragments, as well as for the assessment of fracture healing. Additionally, CT is the imaging technique of choice for the correct diagnosis of subluxations of the distal radioulnar joint. Magnetic resonance imaging is an important diagnostic technique for the evaluation of suspected injuries of soft tissues related to distal radius fractures, such as to the flexor and extensor tendons or the median nerve, and for the early diagnosis of necrosis of the scaphoid or lunate. Other indications include identification of triangular fibrocartilage complex perforations, ruptures of carpal ligaments, and demonstration of contents of the carpal tunnel.

Follow-Up Studies↗

PubMed1993

A practical guide to diagnostic imaging of the upper extremity.

Imaging of the upper extremities can be challenging and rewarding. Newer imaging modalities, including MRI and CT, have greatly expanded the ability of the radiologist to define soft-tissue abnormalities in the wrist, especially triangular fibrocartilage tears and carpal and radioulnar instability. MRI of the shoulder has almost replaced the arthrogram for diagnosing rotator cuff tears. The plain film, however, remains the mainstay of bone imaging and is the most efficacious first step in the diagnostic work-up. The radionuclide scan, although nonspecific, may provide a map for the radiologist to locate occult lesions. Dialogue between the surgeon and radiologist is essential to effective upper extremity evaluations. The radiologist can maximize his or her effectiveness by performing a brief history and physical examination of the patient.

Arm Injuries↗

PubMed1995

[The value of wrist joint arthroscopy in injuries].

UNLABELLED: Wrist arthroscopy clearly shows lesions of carpal bone cartilages, the triangular fibrocartilage (TFC), and of carpal ligaments. Between October, 1993, and August, 1994, 37 out of 47 wrist arthroscopies were performed in the consequence of trauma. The indication was on one hand a joint check for planning further surgery, on the other hand a profound suspicion of a severe intraarticular damage, which was raised in a standardized clinical examination with localizing any points of tenderness, testing for carpal instability, and provoking carpal subluxations and pathological clicks. The standard arthroscopy ports were that between the third and fourth extensor compartment and the radial midcarpal port. RESULTS: 12 of 37 wrist arthroscopies were done within 3 months after trauma. Two patients had fresh cartilaginous lesions, three had severe ligament damages otherwise not diagnosed, and four patients had TFC tears. In all of these nine patients arthroscopy guided the following therapy. 25 arthroscopies were done more than 3 months after trauma. 9 cartilage lesions, 3 ligament tears and 6 TFC defects were demonstrated. In 16 out of these 18 patients the arthroscopic finding was of major influence on further therapy. We conclude that wrist arthroscopy is a powerful tool in diagnosing intraarticular lesions and in planning posttraumatic wrist joint surgery. We suggest that a profound suspicion of intraarticular damage, as gained in a standardized clinical examination, should lead to wrist arthroscopy within one or two weeks after trauma.

Adolescent↗

PubMed1996

[Arthrography of the wrist joint in acute trauma].

At least 20-25% of the patients with distal radius fractures show concomitant lesions of the intrinsic ligaments of the proximal carpal row and lesions of the triangular fibrocartilage complex. A high number of these lesions cause persistent pain and discomfort, even if there is a good radiological result. Wrist arthrography as a screening method can identify these lesions and help to select the patients in whom further diagnostic and therapeutic procedures (diagnostic arthroscopy, arthroscopical refixation of the discus or SL stabilization) should be performed. Wrist arthrography also allows cartilage lesions to be detected, as well as associated fractures or lesions of the capsular ligaments. The technique of wrist arthrography in the acute traumatized wrist, which is different from wrist arthrography in patients suffering from chronic post-traumatic pain, is described in this paper.

Arthrography↗

PubMed1996

Soft-tissue injuries of the wrist.

The wide spectrum of athletic activities places demands of different magnitudes, orientations, and degrees of repetition on the wrists of athletes. These demands can result in injuries to the soft tissues of the wrist, which may make optimal athletic performance difficult if not impossible. With the advent of increased awareness of injuries particular to a sport and advances in diagnostic acumen, both technologic and clinical, these once enigmatic pathologic entities can be approached with a treatment plan that often can return the athlete to competition quickly. A number of these injuries and their pathomechanics, diagnosis, and treatment options have been described in this article. Although adequate treatment of the subject of athletic soft-tissue injuries to the wrist requires a more lengthy discussion than is appropriate here, the material presented on dorsal pain disorders, carpal instability, and the triangular fibrocartilage complex should serve as a starting point for increasing cognizance and understanding of the injured wrist in the athlete.

Athletic Injuries↗

PubMed1996

[Radiologic skeletal diagnosis: traumatology of the distal forearm, the wrists and the hand].

Plain X-ray films including some special radiographic views are still the basis of the radiological evaluation of injuries of the distal forearm, the wrist, and the hand. Especially in the diagnosis of fractures of the distal radius the exact positioning of the arm and hand is essential. For the description of fractures of the distal forearm the AO classification of fractures should be used, which is comprehensive and universally applicable. Conventional tomography and computed tomography (CT) of the radio-ulnar joint and the wrist are used in patients with persisting complaints or equivocal findings on plain radiographs, and difficult anatomical situations. Suspected ligamentous injuries of the wrist including tears of the triangular fibrocartilage complex (TFCC) are evaluated by wrist arthrography or magnetic resonance imaging (MRI), the latter requiring a highly skilled imaging and interpretation technique. MRI is the method of choice for the detection of osteonecrosis. Ultrasound examination are of minor importance in the work up of wrist and hand injuries.

Arthrography↗

PubMed1996

[Ulnodorsal impingement syndrome: meniscus lesions of the wrist].

In a consecutive series of 166 wrist arthroscopies, a lesion of the meniscus was found in 16 patients. All of them complained of ulnar wrist pain evoked by axial load in extension. 14 patients had previous wrist trauma. The preoperative physical examination showed marked ulnodorsal tenderness on palpation and the examiner could feel crepitation by passive motion in the radial-ulnar direction. The meniscus represents a part of the triangular fibrocartilage complex (TFCC). At this time it is not possible by magnetic resonance imaging (MRI) to differentiate between articular disc and meniscus lesion. In contrast the two structures are clearly identifiable by arthroscopy especially if there is a radial tear through the meniscus or even a complete avulsion from its insertion on the palmar aspect of the triquetrum. The avulsed part of the meniscus can prolapse into the ulnocarpal joint, causing an impingement phenomenon.

Adolescent↗

PubMed1997

MR imaging of injuries to the small joints.

This article describes MR imaging of acute and chronic injuries of the ankle and foot, elbow, and hand and wrist. Conditions discussed include ligament and tendon injuries, fractures and bone bruises, osteochondral defects, foreign bodies, and posttraumatic ganglions. Other topics covered include fasciitis, nerve and muscle injuries about the elbow, and triangular fibrocartilage tears.

Acute Disease↗

PubMed1997

Disorders of the distal radioulnar joint.

Disorders of the distal radioulnar joint can be classified into functional abnormalities based on instability, incongruity of the joint surface, impaction, and isolated triangular fibrocartilage complex tears. Knowledge of the type of lesion aids in selecting the treatment option best suited to correcting each problem. This review begins by summarizing the anatomy of the distal radioulnar joint. It then examines the various clinical problems that may arise in this complicated anatomic area and outlines the different surgical and nonsurgical options available to treat these disorders. The most important aspect in treatment of disorders of the distal radioulnar joint is early recognition, followed by prompt appropriate surgical or nonsurgical management.

Algorithms↗

PubMed1997

Management of complex dislocations of the distal radioulnar joint.

The authors reviewed their experience in the treatment of complex dislocations of the distal radioulnar joint. Six cases of complex dislocations were treated between 1990 and 1993. An algorithm for the treatment of these injuries has been developed. In most cases, complex dislocations are associated with an avulsion fracture of the ulnar styloid. The authors prefer to treat these by fixation of the ulnar styloid using a tension band wiring technique. Cases in which the ulnar styloid fragment is small, or in which there is no styloid fracture, are treated with open reduction and repair of the triangular fibrocartilage complex if the distal radioulnar joint is irreducible, or by ulnoradial transfixion pinning if the distal radioulnar joint is reducible but unstable. Good results were obtained in five of six cases using this algorithm.

Adolescent↗