PubMed Health⌕ Search

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 73 records · Page 4Linked to original sources
PubMed2001

The holmium:yttrium-aluminum-garnet laser in wrist arthroscopy: a five-year experience in the treatment of central triangular fibrocartilage complex tears by partial excision.

Arthroscopic debridement of the articular disk is an accepted method for the treatment of symptomatic central tears of the triangular fibrocartilage complex. Current techniques use punches, knives, and shavers to debride the torn disk back to a stable peripheral rim. The holmium:yttrium-aluminum-garnet laser offers an alternative method for disk debridement with potential advantages of enhanced speed, precision, and hemostasis. We present a retrospective review of 35 patients who underwent arthroscopic laser debridement for a Palmer type IA tear in the triangular fibrocartilage complex. Overall response to treatment was good to excellent in 68% of patients and return to work was seen in 88%. One patient developed a deep wound infection. Clinical results after arthroscopic laser debridement are comparable to those reported by other investigators using conventional techniques.

Adolescent↗
PubMed2005

Arthroscopic suture repair of peripheral tears of triangular fibrocartilage complex using a volar portal.

Surgical repair of a Palmer type IB triangular fibrocartilage complex (TFCC) tear can be difficult using conventional dorsal portals and it may need special repair kits. The authors describe an arthroscopic technique using an additional volar portal that allows quick access and a secure purchase of peripheral TFCC tears as well as a distinct approach to dorsal wrist structures.

Arthroscopy↗
PubMed1989

Triangular fibrocartilage complex lesions: a classification.

Based on anatomic and biomechanical studies and review of our clinical experience of the past 10 years, a classification of injuries to the triangular fibrocartilage complex is presented. This classification is based on the clinical examination, routine x-ray films, wrist arthrograms, wrist arthroscopy, and wrist arthrotomy. The classification recognizes both traumatic and degenerative lesions. Traumatic lesions are classified according to their location. Degenerative lesions are classified by the location and severity of degenerative changes of the triangular fibrocartilage complex, ulnar head, ulnocarpal bones and lunotriquetral ligament.

Biomechanical Phenomena↗
PubMed1995

Congenital perforations of the triangular fibrocartilage of the wrist.

A cadaveric study of the triangular fibrocartilage of the wrist in the foetus and infant revealed a high incidence of congenital perforation. In the second half of the study, wrist arthrography in foetal and infant cadavers with crown-rump length of more than 20 cm followed by dissection of the wrist joints showed good correlation between the two. In 60 cadavers there were 11 with bilateral perforations and five had unilateral perforation. This gave a total of 27 perforations in 120 wrist joints studied.

Arthrography↗
PubMed2001

Triangular fibrocartilage complex tears in the athlete.

The treatment of triangular fibrocartilage tears in the athlete presents more of a rehabilitation challenge than a surgical technique challenge. The rehabilitation regimen is a function of the sport. Although injuries to the shoulder and knee can be career ending, injuries to the TFCC usually, but not always, can be treated successfully.

Arthroscopy↗
PubMed1993

Strains in the articular disk of the triangular fibrocartilage complex: a biomechanical study.

The articular disk of the triangular fibrocartilage complex was studied using a video imaging system in a cadaveric laboratory experiment. Changes in disk configuration consistently occurred during pronation and supination and resulted in a nonuniform strain distribution that was dependent upon forearm position. Strains occurred primarily in the radioulnar axis of the disk, with dorsoanterior strains being negligible. Strains were concentrated in the radial portion of the disk and were highest with the forearm pronated. Application of a distraction load to the distal radioulnar joint to simulate the effect of axial wrist loading caused strains to increase the most in the radial portion. These findings suggest that joint distraction loading and forearm pronation are important components of the injury mechanism for the most common type of traumatic tear that occurs near the radial attachment of the disk.

Adult↗
PubMed2005

Reconstructive procedure for unstable radial-sided triangular fibrocartilage complex avulsions.

PURPOSE: Radial-sided avulsions of the triangular fibrocartilage complex (TFCC) (Palmer 1D) with distal radioulnar joint (DRUJ) instability remain a challenging pathology to treat. We tested an intra-articular reconstruction that addresses unstable radial-sided TFCC avulsions. METHODS: Ten preserved, dissected, cadaveric forearm specimens with intact TFCC and without ulnar-positive variance had biomechanical testing using a hydraulic testing device. The measurement of total displacement of the ulna relative to the radius was performed with an applied load ranging from 20 N in a volar direction to 20 N in a dorsal direction. Specimens were tested sequentially with intact TFCC, with surgically induced Palmer 1D lesions, and after reconstruction of the TFCC. All tests were performed at neutral, maximal pronation, and maximal supination. RESULTS: The mean total displacements of the DRUJ of the specimens at neutral rotation were as follows: 4.1 +/- 0.4 mm for the intact specimens compared with 11.8 +/- 0.8 mm after creation of the tear and 3.9 +/- 0.7 mm for the reconstructed specimens. In maximal pronation the mean total displacements were as follows: 2.4 +/- 0.3 mm intact versus 4.9 +/- 0.7 mm for torn and 2.1 +/- 0.3 mm after reconstruction. In maximal supination the mean total displacements were as follows: 1.4 +/- 0.2 mm intact versus 5.7 +/- 1.3 mm for torn and 1.0 +/- 0.1 mm after reconstruction. All specimens obtained the preoperative pronation and supination motion after the reconstruction. CONCLUSIONS: Current procedures are unable to restore DRUJ stability without a significant limitation of pronation and supination. This intra-articular reconstruction of radial-sided TFCC avulsions succeeded in restoring baseline stability to the DRUJ without interfering with pronation/supination.

Biomechanical Phenomena↗
PubMed1996

New Tuohy needle technique for triangular fibrocartilage complex repair: preliminary studies.

The treatment of injuries to the triangular fibrocartilage complex (TFCC) has evolved from closed casting through open excision to arthroscopic repair. The authors present the preliminary results of arthroscopic repair of peripheral (Palmer type IB) TFCC tears using a Tuohy needle. Results in 17 patients treated with this technique were obtained retrospectively through chart review and telephone interview. Average age of the patients was 33 years (range, 16 to 54 years). Conservative treatment averaged 9 months (range, 2 to 26 months). The repairs were performed with one or two horizontal mattress sutures of 2-0 polydioxanone. Follow-up ranged from 4 to 13 months (average, 8 months). Sixteen patients were satisfied or very satisfied with the result; 1 was not satisfied. No complications occurred. We believe this Tuohy needle technique is practical and cost-effective for the arthroscopic management of peripheral TFCC tears.

Adolescent↗
PubMed1996

Arthroscopic repair of the triangular fibrocartilage complex.

To evaluate the efficacy of arthroscopic repair of the triangular fibrocartilage complex (TFCC), functional outcome was determined after arthroscopic repair of 22 wrists in 21 patients. Average follow-up was 36 months (range, 26 to 48 months) and the patients' average age was 30 years (range, 22 to 38 years). All patients had wrist pain limiting them from work or any sports. Twelve of the 14 patients with positive arthrograms had an avulsion of the TFCC from the sigmoid notch (Palmer type 1D tears). Of the 6 patients with negative arthrograms, 5 had peripheral tears (Palmer type 1B). Five patients had associated lunotriquetral ligament repairs and 7 had ulna shortening osteotomies. There was a significant relief of pain and increase in work and sports activities (P < .01). Postoperative range of motion averaged 86% +/- 9% of the contralateral side and grip strength averaged 82% +/- 20% of the contralateral side. There was a significant correlation between the delay from injury to surgical repair and the final total range of motion and grip strength. Follow-up studies in 15 patients found that the repairs were intact in 12. Arthroscopic repair results in significant relief of pain and an increase in the ability to perform at work or sports.

Adult↗
PubMed2001

Origins and insertions of the triangular fibrocartilage complex: a histological study.

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.

Adolescent↗
PubMed2000

Characteristics of triangular fibrocartilage defects in symptomatic and contralateral asymptomatic wrists.

PURPOSE: To characterize triangular fibrocartilage (TFC) defects in symptomatic and contralateral asymptomatic wrists. MATERIALS AND METHODS: Communicating and noncommunicating defects of the TFC were depicted on bilateral wrist arthrograms in 56 patients with unilateral wrist pain and without associated lesions of the scapholunate or lunotriquetral ligaments. The exact location of each TFC lesion was noted. RESULTS: Communicating defects were noted in 36 (64%) of 56 symptomatic and in 26 (46%) of 56 asymptomatic wrists. Twenty-five (69%) of 36 communicating defects were bilateral. Except for one defect in each group of symptomatic and asymptomatic wrists, all communicating defects were noted radially. Noncommunicating defects were noted in 28 (50%) of 56 symptomatic wrists and in 15 (27%) of 56 asymptomatic wrists. Eleven (39%) of 28 noncommunicating defects were bilateral. On the symptomatic side, 28 of 36 noncommunicating defects (including eight multiple defects) were located proximally at the ulnar side. On the asymptomatic side, 11 of 17 noncommunicating defects (including two multiple defects) were at or near the ulna. CONCLUSION: Noncommunicating TFC defects, which typically are located on the proximal side of the TFC near its ulnar attachment, have a more reliable association with symptomatic wrists than do communicating defects. Radial-sided communicating defects described in the literature (Palmer type 1A and 1D) as posttraumatic commonly are seen bilaterally and in asymptomatic wrists.

Adolescent↗
PubMed1992

Traumatic disruption of the triangular fibrocartilage complex. Pathoanatomy.

The surgical pathology in 42 cases of traumatic triangular fibrocartilage complex (TFCC) disruption comprised a spectrum of injury resulting in five basic stages of increasingly severe ulnar wrist instability. In all cases, detachment of the articular disk from its ulnar insertion was the principal cause of distal radioulnar joint instability; in 28 (67%), concomitant injury to the adjacent extensor carpi ulnaris sheath, the ulnocarpal ligaments, or the peritriquetral ligaments compounded the instability. Thus, rather than an isolated event, peripheral disruption of the disk often proved the major constituent of multicomponent lesions--lesions consistently suitable for repair. In this series of destabilizing TFCC disruption requiring operative treatment, awareness that some injuries selectively affect the articular disk, whereas others compromise wider zones of wrist anatomy, was essential to successful surgery.

Adolescent↗
PubMed1995

[Triangular fibrocartilage complex: functional anatomy and histology].

The functional anatomy and histology of triangular fibrocartilage complex (TFCC) were investigated using 20 wrists from fresh cadavers, and a functional model of TFCC was proposed. The dynamic changes in the TFCC during pronation and supination were examined from both the proximal and distal sides. The distal side of the TFCC consisted of the disc proper (DP), the meniscus homologue (MH), the ulnolunate ligament (UL), and the ulnotriquetral ligament (UT). The prestyloid recess was observed between the DP and MH. The ulnar collateral ligament (UCL) existed at the ulnar side of the TFCC and consisted of the sheath floor of the extensor carpi ulnaris (ECU) with relatively loose ligamentous tissue recognized as 6U-portal in arthroscopy. The fan-shaped triangular ligament spreading from the fovea of the ulna was observed on the proximal side of the TFCC. It was considered to be the real radioulnar ligament connecting the radius and ulna. During pronation and supination, little deformity in the DP was observed, while the ulnar insertion of the triangular ligament was twisted. The UCL was distorted dorsally in pronation and volary in supination. In the coronal section of the TFCC, the area surrounded by the DP, MH and UCL was relatively soft and loose, and was considered to have served as a cushion during pronation and supination. From these findings, the TFCC was separated into three components; the distal component which acted like a hammock to suspend the carpus, the triangular ligament as the proximal component which stabilized the radius to the ulna, and the UCL as the ulnar component which stabilized the carpus to the ulna. We have proposed a suspension theory to account for the stability and mobility of the TFCC during pronation and supination when these three components suspend each other. The function of the TFCC can be fully accounted for by our theory.

Adult↗
PubMed1995

MR imaging of the triangular fibrocartilage complex.

This article describes in detail the anatomic components of normal triangular fibrocartilage complex (TFCC) and its MR appearance on high resolution MR images. It also describes pathologic processes of TFCC and its MR appearance.

Cartilage Diseases↗
PubMed2006

Injury of the dorsal sensory branch of the ulnar nerve as a complication of arthroscopic repair of the triangular fibrocartilage.

This report presents a case of direct injury to the dorsal sensory branch of the ulnar nerve caused by arthroscopic repair of the triangular fibrocartilage complex. The dorsal sensory branch of the ulnar nerve was strangulated by one of the three pull-out sutures of the joint capsule, just ulnar to the extensor carpi ulnaris tendon. Pain and dysaesthesia of the ulnar side of the wrist was completely relieved after excision of the injured nerve segment. This complication can be avoided by careful exploration of the dorsal sensory branch of the ulnar nerve prior to suturing or passage of instruments during arthroscopy.

Adult↗
PubMed2005

Arthroscopically assisted repair of peripheral triangular fibrocartilage complex tears: factors affecting outcome.

PURPOSE: The purpose of our study was to identify factors affecting the outcome after arthroscopically assisted repair of peripheral triangular fibrocartilage complex (TFCC) tears. TYPE OF STUDY: Retrospective case series. METHODS: Thirty-five patients who underwent arthroscopic repair of traumatic TFCC tears were enrolled in this study (mean age, 34 +/- 12 years; 22 female and 13 male patients; mean follow-up, 29 months; range, 6 to 82 months). Patients with TFCC tears associated with distal radius fractures, or significant wrist bone or neurovascular pathology were excluded from the study. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score was used as the primary variable during statistical analysis to identify factors determining outcome. RESULTS: The DASH score in this study was 12 +/- 12 points. A significant correlation was found between the age of the patient and the DASH score, indicating that older age has a significant negative effect on functional outcome. Significant correlations were also found between the DASH score and (1) decreased percentage of grip strength compared with the healthy side, (2) decreased supination, and (3) positive postoperative ulnar variance. CONCLUSIONS: Age-related degenerative changes in the wrist might contribute to poor outcome and a TFCC tear resulting from minor or repetitive trauma. Loss of wrist rotation, grip strength, and ulnar positive variance are factors that are correlated with poor outcome. LEVEL OF EVIDENCE: Level IV.

Adult↗
PubMed1987

Arthrographic evaluation of the carpal triangular fibrocartilage complex.

One hundred sixty-two patients had analyses for correlation of triangular fibrocartilage abnormalities (TFCC), with duration and location of pain and other possible associated radiographic, scintigraphic, and arthrographic abnormalities. Results indicated that TFCC perforations did not correlate with any pain complex or other associated radiographic, arthrographic, or scintigraphic abnormality. No association with carpal instability or with ulnar variance could be identified. No definition between perforations that were posttraumatic and those that were the results of a degenerative process could be made. Several small defects on both the proximal and distal surfaces of the TFCC were identified. They do not appear to have been reported previously in the literature. Their significance is discussed.

Adult↗