Central TFCC Debridement: Technique and Indication in the Twenty-First Century

  • Terry L. Whipple
  • Terry L. Whipple
  • Terry L. Whipple


As described in  Chaps. 1 and  2, the anatomy of the triangular fibrocartilage complex (TFCC) is complex, including an important prestyloid synovial recess at the volar, ulnar margin of the disc. The ulnar styloid process is the hub of rotation for the radio-carpal and ulno-carpal joints through pronation and supination of the forearm. The prestyloid recess accommodates the head of the ulna in positions of forearm supination as the TFCC sweeps dorsally across the seat of the ulna. Alternatively, the recess is covered by the volar and central portions of the TFCC in varying degrees of pronation [12] (Fig. 7.1).


Central Disc Proximal Pole Forearm Rotation Forearm Supination Forearm Pronation 
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  1. 1.
    Bernstein MA et al (2004) A comparison of combined arthroscopic triangular fibrocartilage complex debridement and arthroscopic wafer distal ulna resection versus arthroscopic triangular fibrocartilage complex debridement and ulna shortening osteotomy for ulnocarpal abutment syndrome. Arthroscopy 20(4):392–401PubMedCrossRefGoogle Scholar
  2. 2.
    Chloros GD et al (2008) Current concepts in wrist arthroscopy. Arthroscopy 24(3):343–354PubMedCrossRefGoogle Scholar
  3. 3.
    Darlis NA et al (2005) Arthroscopic triangular fibrocartilage complex debridement using radiofrequency probes. J Hand Surg Br 30(6):638–642PubMedCrossRefGoogle Scholar
  4. 4.
    Husby T, Hangsvelt JR (2001) Long term results after arthroscopic resection of lesions of the triangular fibrocartilage complex. Scand J Plast Reconstr Surg Hand Surg 35(1):79–83PubMedCrossRefGoogle Scholar
  5. 5.
    Intanger M, Grimm D (2009) Meniscus and discus lesions of the TFCC: treatment by laser-assisted wrist arthroscopy. J Plast Reconstr Aesthet Surg 62(4):466–471CrossRefGoogle Scholar
  6. 6.
    Palmer A (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am 14A:594–605CrossRefGoogle Scholar
  7. 7.
    Palmer AK, Werner FW (1981) The triangular fibrocartilage complex of the wrist – anatomy and function. J Hand Surg Am 6A:151–162Google Scholar
  8. 8.
    Saffar P (2007) The pathology of the long ulna: anatomy and treatment. J Hand Surg Eur 32(6):608–619Google Scholar
  9. 9.
    Tatebe M et al (2000) Repair of the triangular fibrocartilage complex after ulna-shortening osteotomy: second-look arthroscopy. J Hand Surg 32(4):445–449Google Scholar
  10. 10.
    Tomaino MM, Elfar J (2005) Ulnar impaction syndrome. Hand Clin 21(4):567–575PubMedCrossRefGoogle Scholar
  11. 11.
    Unglaub F et al (2009) Incidence and distribution of blood vessels in punch biopsies of palmer 1A disc lesions in the wrist. Arch Orthop Trauma Surg 129(5):631–634PubMedCrossRefGoogle Scholar
  12. 12.
    Whipple T (1992) Arthroscopic surgery: the wrist. Lippincott, PhiladelphiaGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Terry L. Whipple
    • 1
  • Terry L. Whipple
    • 2
  • Terry L. Whipple
    • 3
  1. 1.American Self, PLCRichmondUSA
  2. 2.Orthopaedic SurgeryVirginia Commonwealth UniversityRichmondUSA
  3. 3.Orthopaedic Research of VirginiaRichmondUSA

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