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Abstract
The triangular fibrocartilage complex (TFCC) is a significant stabilizer of the distal radioulnar joint. Diagnosing TFCC injury is currently difficult, but ultrasonography (US) has emerged as a low-cost, minimally invasive diagnostic tool. We aimed to quantitatively analyze TFCC by performing motion analysis by using US. Twelve healthy volunteers, comprising 24 wrists (control group), and 15 patients with TFCC Palmer type 1B injuries (injury group) participated. The US transducer was positioned between the ulnar styloid process and triquetrum and was tilted ulnarly 30° from the vertical line. The wrist was then actively moved from 10° of radial deviation to 20° of ulnar deviation in a 60-rounds-per-minute rhythm that was paced by a metronome. The articular disc displacement velocity magnitude was analyzed by using particle image velocimetry fluid measurement software. The mean area of the articular discs was larger on ulnar deviation in the control group. The mean articular disc area on radial deviation was larger in the injury group. The average articular disc velocity magnitude for the injury group was significantly higher than that for the control group. The results suggest that patients with TFCC injury lose articular disc cushioning and static stability, and subsequent abnormal motion can be analyzed by using US.
Highlights
The triangular fibrocartilage complex (TFCC) is an important stabilizer of the distal radioulnar joint (DRUJ), serving as a cushion against axial loading in the ulnar carpal joint [1]
The TFCC mainly consists of four structures (Figure 1): the articular disc, meniscus homologue, radioulnar ligaments, and extensor carpi ulnaris (ECU)
Palmer type 1B TFCC injury occurs at the attachment of the ulnar fovea, leading to instability of the DRUJ resulting in pain [2]
Summary
The triangular fibrocartilage complex (TFCC) is an important stabilizer of the distal radioulnar joint (DRUJ), serving as a cushion against axial loading in the ulnar carpal joint [1]. TFCC injuries are the most common causes of ulnar wrist pain. The TFCC mainly consists of four structures (Figure 1): the articular disc, meniscus homologue, radioulnar ligaments, and extensor carpi ulnaris (ECU). The ECU and the articular disc are reported to be important stabilizers of the DRUJ [1]. Palmer type 1B TFCC injury occurs at the attachment of the ulnar fovea, leading to instability of the DRUJ resulting in pain [2]. The attachment to the fovea, termed as the ligamentum subcruentum (Figure 1), has been reported in recent biomechanical studies to contribute significantly to the stability of the DRUJ [3]
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