Palmer classification of TFCC abnormalities

Last revised by Bahman Rasuli on 19 May 2020

Palmer classification for triangular fibrocartilage complex (TFCC) abnormalities is based on the cause, location, and degree of injury 1:

Class 1 - traumatic injury
  • a: central perforation of the triangular fibrocartilage (TFC) disc proper
  • b: ulnar avulsion with or without distal ulnar fracture
    • may involve the proximal or distal lamina (foveal and styloid attachment, respectively), or both
  • c: distal avulsion of the TFCC involving ulnotriquetral and ulnolunate ligaments
  • d: radial avulsion of the TFC disc proper +/- sigmoid notch fracture
Class 2 - degenerative injury (ulnocarpal abutment syndrome)
  • a: TFCC wear with thinning/fraying without perforation
  • b: TFCC wear in 2a with lunate, triquetral and/or ulnar chondromalacia
  • c: TFCC perforation +/- 2b chondromalacia
  • d: lunotriquetral ligament perforation +/ features of 2a, 2b and/or 2c
  • e: any or all of above with ulnocarpal arthritis

See also

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