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Results for “Triangular Fibrocartilage”

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At least 163 records · Page 9Linked to original sources
PubMed1997

Radial avulsion of the triangular fibrocartilage complex in acute wrist trauma: a new technique for arthroscopic repair.

The advantages of arthroscopically assisted treatment of intraarticular distal radius fractures, especially the detection of additional carpal lesions, also focus attention on special surgical techniques for operating on these injuries within the same session. When we consider the biomechanical situation, various kinds of triangular fibrocartilage complex (TFCC) lesions, and their arthroscopic aspects, there are probably two possibilities for surgical treatment that are similar to arthroscopic meniscal surgery: resection of flap tears and the refixation of peripherally disinserted TFCC. Avulsions from the ulnar styloid or from the ulnar collateral ligament and the extensor carpi ulnaris tendon can easily and satisfactorily be treated by convenient arthroscopic suture techniques, whereas the reattachment of the triangular disc in the sigmoid notch is very tricky. This problem is solved by a recently developed procedure using the so-called T-Fix-device (Acufex), which provides the possibility of transosseus refixation by closed arthroscopic procedure and therefore guarantees the principle of minimal invasive surgery.

Arthroscopes↗
PubMed1989

Tears of the triangular fibrocartilage of the wrist: MR imaging.

Magnetic resonance (MR) imaging of the wrist was performed in 35 patients with specific complaints of pain and soft-tissue swelling in the medial side of the wrist. Twenty of the 35 subsequently underwent surgery. In 14 of the patients who underwent surgery, a diagnosis of triangular fibrocartilage (TFC) tear was made at MR imaging; in 13 of the 14 the tear was confirmed by surgical findings. In the six patients with an MR diagnosis of an intact TFC, surgical findings confirmed the diagnosis. These patients were operated on for an abnormality in the vicinity of the TFC (avascular necrosis, ganglion cyst, xanthoma). On the basis of findings from the 20 patients with surgical correlation, the accuracy of MR imaging in the detection of TFC tears was 95%. MR imaging is a valuable noninvasive method in the study of pathologic conditions of the TFC.

Adolescent↗
PubMed1987

The distal radioulnar joint. Anatomy, biomechanics, and triangular fibrocartilage complex abnormalities.

The distal radioulnar joint plays an intricate part in the function of the wrist and thus in the function of the entire upper extremity. The radius and hand move in relation to and function about the distal ulna. Significant loads are transmitted to the forearm unit through the distal ulna via the triangular fibrocartilage complex. The anatomic relationships between the distal radius and ulna and ulnar carpus are precise, and even minor modification in these relationships leads to significant load changes and resultant pain syndromes. Evaluation of a patient with ulnar wrist pain is, at best, difficult. Despite a careful and thorough history and physical examination and the use of sophisticated ancillary diagnostic studies, some patients with distal radioulnar joint and ulnar carpal complex problems remain diagnostic and therapeutic mysteries. These patients are best followed; exploratory surgery is rarely satisfying to either the patient or the surgeon. Armed with an understanding of the normal anatomy and biomechanics, the examination of such a patient and subsequent treatment should become a challenge that is rewarding for both patient and treating physician.

Biomechanical Phenomena↗
PubMed2001

Non-union of the capitate with associated triangular fibrocartilage tear.

We report a case of a 19-year-old boy who presented with a painful wrist 3 months after a fall. Plain radiographs demonstrated a non-union of a capitate fracture which was unrecognised at the time of injury. Magnetic resonance imaging confirmed the diagnosis and also demonstrated a tear of the triangular fibrocartilage complex. This combination of injuries has not been previously described.

Adult↗
PubMed2000

The role of arthroscopy in the evaluation and treatment of triangular fibrocartilage complex injuries in athletes.

Treating athletes with TFCC injuries can be a difficult but very rewarding undertaking. Each athlete has individual priorities and concerns, ranging from general health and fitness for the recreational athlete to earning or potentially earning a living as a professional athlete. It is crucial for the treating surgeon to understand these issues to offer the appropriate treatment options at the appropriate time. Triangular fibrocartilage complex injuries are quite common in athletes because of the high loads placed on the ulnar side of the wrist, especially with ulnar-neutral and positive variance. The goal of treatment for the competitive athlete with a TFCC lesion is to hasten maximal recovery and return the athlete to participation at the pre-injury level of performance. Early wrist arthroscopy and treatment of TFCC pathology in this population is certainly a real and valuable treatment option. As has been stated, "the TFCC is the new frontier of wrist surgery" and arthroscopy has helped blaze the trail to this frontier. Competitive and recreational athletes alike benefit from arthroscopic treatment of their TFCC injuries.

Arthroscopy↗
PubMed2002

Injury to the dorsal sensory branch of the ulnar nerve in the arthroscopic repair of ulnar-sided triangular fibrocartilage tears using an inside-out technique: a cadaver study.

This anatomic study of the commonly described inside-out Tuohy needle technique was performed to better define the course of needle passage relative to the anatomic structures in this region including the dorsal sensory branch of the ulnar nerve (DBUN) and extensor carpi ulnaris (ECU) tendon. Ten fresh-frozen cadaver specimens had arthroscopic-guided passage of a Tuohy needle through the triangular fibrocartilage (TFC). Dissection of the ulnar side of the wrist was performed and various measurements were recorded. The average minimum distance between suture A (the suture closest to the nerve) and the DBUN was 1.9 mm. The average minimum distance between suture B and the DBUN was 2.7 mm. The distance between the 2 sutures at the level of the capsule averaged 6.2 mm. The distance between the DBUN and the ECU averaged 7.2 mm. In 5 of 10 specimens the sutures exited on opposite sides of the DBUN. The DBUN is variable in its course but in every case it passes in close proximity to the sutures that exit the ulnar side of the wrist in arthroscopic repair of ulnar-sided TFC tears.

Arthroscopy↗
PubMedDate not supplied

Triangular fibrocartilage and intercarpal ligaments of the wrist: does MR arthrography improve standard MRI?

The objective of this study was to assess the value of adding MR arthrography to standard MRI for patients with chronic wrist disorders. Thirty consecutive patients (age range, 19-73 years; mean, 36.2 years) were included in the investigation. The images were evaluated blindly and separately by two radiologists with regard to lesions of the scapholunate (SL) and lunotriquetral (LT) ligaments and the triangular fibrocartilage (TFC). Conventional two- or three-compartment arthrography was used as the standard of reference. For TFC lesions, standard MR images had a sensitivity of 92.3% (reader 1) and 84.6% (reader 2) and a specificity of 41.2% (reader 1) and 52.9% (reader 2). For MR arthrography, sensitivity was 84.6% (reader 1) and 84.6% (reader 2) and specificity was 88.2% (reader 1) and 100% (reader 2). For SL ligament tears, standard MRI had a sensitivity of 33.3% (reader 1) and 11.1% (reader 2) and a specificity of 47.6% (reader 1) and 57.1% (reader 2). For MR arthrography, sensitivity was 66.7% (reader 1) and 55.6% (reader 2) and specificity was 52.4% (reader 1) and 81.0% (reader 2). For LT ligament tears, standard MRI had a sensitivity of 28.6% (reader 1) and 35.7% (reader 2) and a specificity of 93.8% (reader 1) and 81.3% (reader 2). For MR arthrography, sensitivity was 35.7% (reader 1) and 23.1% (reader 2) and specificity was 93.8% (reader 1) and 94.1% (reader 2). In conclusion, the diagnostic performance of MRI in suspected lesions of the TFC and the SL and LT ligaments is improved by adding MR arthrography to the standard examination.

Adult↗
PubMed2004

MR imaging of ligaments and triangular fibrocartilage complex of the wrist.

Imaging of the wrist with MR imaging can be difficult because of the small size of this joint, its complex anatomy, and its sometimes poorly understood pathologic lesions. A recent study by Hobby and coworkers of 98 patients revealed that MR imaging of the wrist influences clinicians' diagnoses and management plans in most patients. This article summarizes the current diagnostic criteria that can be useful in interpreting abnormalities of the wrist ligaments and triangular fibrocartilage complex (TFCC) of the wrist in this difficult topic in joint MR imaging.

Carpal Bones↗
PubMed2003

Surgical approach to the triangular fibrocartilage complex.

There are few descriptions of the surgical exposure of the ulnar aspect of the wrist. The anatomy of the dorsoulnar aspect of the wrist was explored in 7 cadaver wrists with special attention to developing a surgical approach to the dorsum of the radio-ulno-carpal joint. Using the experience from previous authors and the knowledge gained from our cadaveric dissections, a surgical approach was designed that provides wide exposure of the dorsoulnar aspect of the wrist. The anatomic layers are dissected in a distinct pattern that allows preservation of the extensor carpi ulnaris and its sheath as well as a strong closure of each layer and restoration of the anatomy. Minimal postoperative immobilization is required, and rehabilitation can be started as early as 2 weeks postoperatively. This approach provides access to the distal radioulnar joint, triangular fibrocartilage complex, distal ulna, and lunotriquetral joint, thus allowing multiple possible procedures through a single, universal approach.

Journal Article↗
PubMed2006

Pediatric distal radius fractures and triangular fibrocartilage complex injuries.

Management of distal radius fractures is guided by the pattern and location of injury, degree of deformity, and expectations of bony remodeling based on the amount of remaining skeletal growth.Indications for surgical treatment include unstable or irreducible fractures, open fractures, floating elbow injuries, and neurovascular or soft-tissue compromise precluding cast immobilization. Patients and families should be counseled regarding the potential for post-traumatic distal radial growth arrest following physeal fractures. In these cases, epiphysiodeses, ulnar shortening osteotomies, or corrective radial osteotomies may be performed, depending on the pattern of arrest,degree of deformity, and remaining skeletal growth.TFCC tears may be the source of ulnar-sided wrist pain in children and adolescents, though symptoms and physical examination findings maybe subtle. Patients who have persistent pain and functional limitations despite activity modification and therapy are candidates for surgical treatment. Appropriate repair of peripheral TFCC tears with correction of concomitant wrist pathology restores normal wrist anatomy, alleviates pain, and allows for return to functional activities.

Arthroscopy↗
PubMed1978

Age changes in the triangular fibrocartilage of the wrist joint.

On the basis of a study of 180 wrist joints from 100 fresh cadavers of individuals ranging in age from fetuses to 94 years, it is concluded that the triangular fibro-cartilage is very liable to degenerative alterations associated with ageing. Degeneration begins in the third decade and progressively increases in frequency and severity in subsequent decades. The changes comprise reduced cellularity, loss of elastic fibres, mucoid degeneration of the ground substance, exposure of collagen fibres, fibrillation, erosion, ulceration, abnormal thinning, and, ultimately, disc perforation. The changes are more frequent and more intense on the ulnar surface, and they are always situated in the central part of the disc. It appears that disc perforation is degenerative and age-related: thus there were no perforations in the first two decades of life; in the third there were 7.6%, in the fourth 18.1%, in the fifth 40.0%, in the sixth 42.8%, and in the over sixties 53.1%. There was an associated pattern of degenerative changes in the wrist joint as a whole. The structures adjacent to the articular disc (discal surface of the ulnar head, discal part of the lunate) were much more often involved, and the changes were much more advanced, than on non-discal surfaces. It is argued that this is because of more intensive biomechanical forces, particularly rotational forces, in the disc compartment of the joint.

Adolescent↗
PubMedDate not supplied

Lesions of the triangular fibrocartilage in fractures of the wrist.

MRI conducted in 32 cases of distal fracture of the radius a mean of 93 days after trauma allowed for the identification of various lesions of the soft tissues among which those of the triangular fibrocartilaginous complex. These observations confirm the presence of lesions of the triangular fibrocartilaginous complex (TFC) among immediate complications of distal fractures of the radius and the diagnostic role of MRI in post-traumatic ulnar pain.

Adolescent↗