The Triangular Fibrocartilage Complex

The triangular fibrocartilage complex (TFCC) is the primary stabilizer of the distal radioulnar joint (DRUJ). It also absorbs stress during axial loading of the wrist and limits lateral deviation of the carpus. The main components of the TFCC are the triangular fibrocartilage, the dorsal and volar radioulnar ligaments, the volar ulnolunate and ulnotriquetral ligaments, the meniscus homologue, the ulnar collateral ligament, and the extensor carpi ulnaris tendon sheath [15-19]. The complex anatomy of the TFCC has been studied with high-resolution MRI using microscopy coils [19], virtual MR arthroscopy [20], and recently 3-Tesla MRI (3TMR) imaging [21].

The head of the ulna and the sigmoid notch of the radius form the proximal osseous boundary of the TFCC. The distal osseous border is composed of the triquetrum and medial portion of the lunate. The triangular fibrocartilage inserts into the ulnar aspect of the lunate fossa of the radius and, through the upper and lower lamina of the ligament, into the ulnar styloid and into the fovea at the base of the ulnar styloid (Fig. 3; see Fig. 2). Occasionally, the ulnar insertion may span the entire length of the ulnar styloid process without distinct separation into bands [22,23]. Distally, the TFCC inserts into the hamate, tri-quetrum, and base of the fifth metacarpal and blends with fibers of the ulnar collateral ligament [15]. Volarly, the TFCC is attached to the triquetrum and lunate by the ulnotriquetral and ulnolunate ligaments, respectively. Dorsally, the TFCC is incorporated into the sheath of the extensor carpi ulnaris tendon

The meniscus homologue is a complex fibrous structure that resides between the ulna and triquetrum (see Fig. 2). It has a common origin with the dorsal radioulnar ligament and inserts into the ulnar border of the triquetrum.

Tfcc Meniscus Homologue Mri

Fig. 3. Normal anatomy—triangular fibrocartilage. Oblique coronal gradient echo T2*-weighted image shows the radial (arrow) and ulnar (open arrows) insertions of the triangular fibrocartilage. Note cartilage undercutting at the radial attachment of the ligament and not the frequently encountered heterogeneity at the insertion to the ulnar styloid.

Fig. 3. Normal anatomy—triangular fibrocartilage. Oblique coronal gradient echo T2*-weighted image shows the radial (arrow) and ulnar (open arrows) insertions of the triangular fibrocartilage. Note cartilage undercutting at the radial attachment of the ligament and not the frequently encountered heterogeneity at the insertion to the ulnar styloid.

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Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

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Responses

  • rick
    What is cartilage undercutting?
    8 years ago

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