TFCC surgery is also indicated when conservative treatment proves insufficient in about 8–12 weeks. The load that is transmitted across the TFC is then increased. [citation needed], The ligaments are composed of longitudinally oriented lamellar collagen to resist tensile loads and have a rich vascular supply to allow healing. The TFCC is at risk for either acute or chronic degenerative injury. She has also developed a conservative management protocol for the treatment of TFCC tears after 12 years of research around the globe. This central area is often so thin that it is translucent and in some cases it is even absent. Arthrography: a dye is injected into the wrist joint. If the fracture is treated surgically it is recommended to evaluate and if necessary repair the TFCC as well. X-ray: X-rays of the wrist are made in two directions: posterior-anterior (PA) and lateral. Im Handgelenk dient der TFCC vor allem als Gelenkverbindung und sorgt zusätzlich für erhöhte Stabilität. Traumatic disruption of the triangular fibrocartilage complex. Patients with a TFCC injury usually experience pain or discomfort located at the ulnar side of the wrist, often just above the ulnar styloid. The TFCC consists of an articular disc, meniscus homologue, ulnocarpal ligament, dosal & volar radioulnar ligament and extensor carpi ulnaris sheath.Origin: Medial border of distal radius Insertion: Base of ulnar styloid Vascular Supply: central disc is avascular, peripheral blood vessels penetrate TFCC margins Function of TFCC: 1. Piano key sign: dorsal DRUJ instability can cause a protruding ulna head, which can be pressed down. [11] Triangular fibrocartilage tears. [citation needed]. The triangular fibrocartilage complex (TFCC) plays an important role in the stability and mobility of the ulnar side wrist. 1 2 Patient with TFCC tear usually claims ulnar-sided wrist pain, click, instability of the distal radioulnar joint (DRUJ), decrease of power grip, and loss of range of wrist and forearm motion. There is an age related correlation with lesions in the TFCC, but many of these defects are asymptomatic. The triangular fibrocartilage complex (TFCC) is a load-bearing structure that sits on the pinky side of the palm between the wrist and the hand- or more specifically between the lunate, triquetrum, and ulnar head. Shortening the ulnar bone may help relieve the excess pressure to the TFCC and prevent further degeneration. The triangular fibrocartilage complex of the wrist was serially sectioned for routine histology. In cadavaric examinations, 30% to 70% of the cases had TFCC perforations and chondromalacia of the ulnar head, lunate and triquetrum. The TFCC plays an important role in stabilizing this side of the wrist. Forced ulnar deviation a … Finally tears of the TFCC are frequently found by patients with distal radius fractures. To control the forearm rotation the DRUJ acts in concert with the proximal radioulnar joint. The deep components insert more anterior, into the fovea adjacent to the articular surface of the dome of the distal ulna. This positive ulnar variance occurs during pronation. concluded that the dorsal fibers of the TFCC tighten in pronation, and the palmar fibers in supination. Triangular fibrocartilage complex is a major stabilizer of the distal radioulnar joint (DRUJ). These ligaments prevent dorsal migration of the distal ulna. They originate from the ulnar styloid and insert into the carpal bones of the wrist: the ulnolunate ligament inserts into the lunate bone and the ulnotriquetral ligament into the triquetrum bone. Nonoperative management can be effective for certain injury patterns. The Triangular fibrocartilage complex (TFCC) is formed by the triangular fibrocartilage discus (TFC), the radioulnar ligaments (RULs) and the ulnocarpal ligaments (UCLs). Tiny as it is, the TFCC is an essential component in your wrist for gripping objects like a baseball bat, for weight-bearing exercises, and any wrist rotation exercise such as tennis. Fax: 0201 - 371 90 84 Its function is to provide stability, cushioning and smooth movement in the wrist joint. They are more taut during supination, because in supination ulnar styloid moves away from the carpal bones volar side.[1][5]. The connection between the distal radius and the distal ulna, maintain the congruency of the DRUJ. Patients with a positive ulnar variance are more susceptible to TFCC damage. The TFCC is composed of ligaments that connects the forearm bones and a piece of cartilage that provides a smooth joint surface. Pathoanatomy. This procedure is indicated for DRUJ instability caused by an irreparable TFCC. Disruption of this area through injury or degeneration can cause more than just a wrist sprain. The Triangular Fibrocartilage Complex (TFCC) is an area between your radius and ulna, the two main bones that make up your forearm. : Triangular fibrocartilage complex, daher die Abkürzung TFCC), der auch ulnokarpaler Komplex genannt wird, ist eine dreieckig geformte Faserknorpelscheibe, die sich zwischen den Gelenkknochen des menschlichen Handgelenks befindet. The physician then applies axial load, while he rotates and deviates the wrist in ulnar direction. The load transmission is directly proportional to this ulnar variance. Each ligament consists of a superficial component and a deep component. Triangular fibrocartilage complex lesions: a classification. With positive ulnar variance it is reversed. As the name suggests, the soft tissues of the wrist are complex. Mild injuries of the TFCC may be referred to as a wrist sprain. [9][8], Suturing TFCC ligaments can sometimes be performed arthroscopically. The TFCC is made of tough fibrous tissue and cartilage. The triangular fibrocartilage complex of the wrist-Anatomy and function The anatomy and function of the triangular fibrocartilage complex (TFCC) of the wrist was studied through anatomic dissections and biomechanical testing of 61 specimens. The function of the TFCC is to act as a stabilizer for the ulnar aspect of the wrist. Histologic anatomy of the triangular fibrocartilage. The tendon graft is tunnelled through drilled holes in the ulnar and radius bones. 1983;8:620. It also supports the ulnar portion of the carpus. Nevertheless, the incidence of false-positive and false-negative MRI results is high. $39.00. Katernberger Straße 107 E-Mail: info@ziff.de, Fortbildungen für Logopäden und Sprachtherapeuten, Heilpraktiker Ausbildung Quereinstieg noch möglich, Marburger Konzentrationstraining (MKT) online, neue zertifizierte Ausbildung: Trauma Intensiv – Traumafachberatung und Traumapädagogik. Methods. Palpation: the best place to palpate the TFCC is between the extensor carpi ulnaris (ECU) and the flexor carpi ulnaris (FCU), distal to the ulnar styloid and proximal to the pisiform bone. The triangular fibrocartilage complex (TFCC) is a load-bearing structure between the lunate, triquetrum, and ulnar head. This attachment is mainly created by the RUL's of the TFCC. [9] The immobilization allows scar tissue to develop which can help heal the TFCC. Methods . Categories Muscles Tendons Tags Hand, Knee, Muscles Tendons, Spine, Wrist Post navigation. Triangular fibrocartilage complex (TFCC) injuries of the wrist affect the ulnar (little finger) side of the wrist. When you release the pressure, it will spring back in position again, just like a piano key. Injuries to the TFCC can cause wrist pain and clicking sensations. Patients may be advised to wear a temporary splint or cast to immobilize the wrist and forearm for four to six weeks. During supination, the superficial palmar and the deep dorsal ligaments are tightened[citation needed], preventing palmar translation of the ulna. Injuries to the TFCC may be preceded by a fall on a pronated outstretched arm; a rotational injury to the forearm; an axial load trauma to the wrist; or a distraction injury of the wrist in ulnar direction. Anchors articular disc between ulna and proximal Carpal Bones of the wrist; Cushions weight-bearing forces while grasping; Helps to stabilize the distal radial-ulnar joint Die Enden von Elle (Ulna) und Speiche (Radius) des Arms werden darin fest miteinander und auch mit dem Handwurzelknochen verbunden. 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