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High-resolution 3-T MRI of the triangular fibrocartilage complex in the wrist: injury pattern and MR features

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Abstract

Objectives

To investigate if using high-resolution 3-T MRI can identify additional injuries of the triangular fibrocartilage complex (TFCC) beyond the Palmer classification.

Materials and methods

Eighty-six patients with surgically proven TFCC injury were included in this study. All patients underwent high-resolution 3-T MRI of the injured wrist. The MR imaging features of TFCC were analyzed according to the Palmer classification.

Results

According to the Palmer classification, 69 patients could be classified as having Palmer injuries (52 had traumatic tears and 17 had degenerative tears). There were 17 patients whose injuries could not be classified according to the Palmer classification: 13 had volar or dorsal capsular TFC detachment and 4 had a horizontal tear of the articular disk.

Conclusion

Using high-resolution 3-T MRI, we have not only found all the TFCC injuries described in the Palmer classification, additional injury types were found in this study, including horizontal tear of the TFC and capsular TFC detachment. We propose the modified Palmer classification and add the injury types that were not included in the original Palmer classification.

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Acknowledgements

This study was funded by the National Natural Science Foundation of China (grant number 81371515), the Beijing Natural Science Foundation of China (grant number 7142075), the Capital Medical Development and Scientific Research Fund of China (grant number 2016-2-1122).

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    Authors and Affiliations

    1. Department of Radiology, Peking University Fourth School of Clinical Medicine, No.31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China

      Huili Zhan, Rongjie Bai, Zhanhua Qian, Yue Liu & Heng Zhang

    2. Department of Radiology, Beijing Chaoyang Hospital of Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China

      Huibo Zhang

    3. Department of Radiology, Beijing Jishuitan Hospital, Beijing Institute of Traumatology and Orthopedics, No.31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China

      Rongjie Bai & Zhanhua Qian

    4. Radiology Associates, LLP, 1814 South Alameda Street, Corpus Christi, TX, 78404, USA

      Yuming Yin

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    1. Huili Zhan
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    Correspondence to Rongjie Bai.

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    The authors declare that they have no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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    Informed consent was obtained from all individual participants included in the study.

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    Rongjie Bai and Yuming Yin contributed equally to this work

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    Zhan, H., Zhang, H., Bai, R. et al. High-resolution 3-T MRI of the triangular fibrocartilage complex in the wrist: injury pattern and MR features. Skeletal Radiol 46, 1695–1706 (2017). https://doi.org/10.1007/s00256-017-2739-x

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    • DOI: https://doi.org/10.1007/s00256-017-2739-x

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