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Anatomy of the Triangular Fibrocartilage Complex

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Wrist and Elbow Arthroscopy

Abstract

Ulnar-sided wrist pain is a common presenting complaint, so a thorough understanding of the anatomy and biomechanics of the triangular fibrocartilage complex (TFCC) and distal radioulnar joint (DRUJ) is essential for the diagnosis and treatment of these disorders. Over the past 30 years, the knowledge of this complicated structure and its role in the biomechanics of the wrist has increased, leading to improved diagnoses of these injuries and to more effective reconstructive procedures for their treatment.

The TFCC is a critical and complex structure that contributes to both load transmission from the carpus to the ulna, and to the stability of the ulnocarpal and the distal radioulnar joints. This structure, acting as an extension of the surface of the radius to transmit forces through the ulnocarpal joint, is typically responsible for approximately 20 % of the load across the joint, but with variations in anatomy this relationship can change. The ulnocarpal ligament components of the TFCC contribute very little to DRUJ stability, but contribute significantly to ulnocarpal stability. Due to the extremely limited inherent bony stability of the DRUJ, the major stabilizer of this joint is the TFCC, with the palmar and dorsal radioulnar ligaments playing the most vital role in this process.

Arthroscopy allows an unparalleled visual examination of the different components of the TFCC, which can aid in differentiating pathologic versus normal anatomy. With this improved ability to see fine details and structures that might go unappreciated in open approaches, the surgeon should possess a comprehensive understanding to guide decision making and treatment during surgery. In addition to covering the anatomy of the TFCC and the DRUJ along with their functional role in the wrist, this chapter also describes normal arthroscopic findings of these structures.

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Authors and Affiliations

  1. Alabama Orthopaedic Clnic, 3610 Springhill Memorial Dr N, Mobile, AL, 36608, USA

    Jared L. Burkett M.D.

  2. Department of Orthopaedic Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA

    William B. Geissler M.D.

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  1. Jared L. Burkett M.D.
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  2. William B. Geissler M.D.
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Correspondence to Jared L. Burkett M.D. .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, University of Mississippi, Jackson, Mississippi, USA

    William B. Geissler

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Burkett, J.L., Geissler, W.B. (2015). Anatomy of the Triangular Fibrocartilage Complex. In: Geissler, W. (eds) Wrist and Elbow Arthroscopy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1596-1_4

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  • DOI: https://doi.org/10.1007/978-1-4614-1596-1_4

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