Triangular fibrocartilage complex
Citation, DOI, disclosures and article data
Citation:
Knipe H, Campos A, Yu Y, et al. Triangular fibrocartilage complex. Reference article, Radiopaedia.org (Accessed on 16 Mar 2025) https://doi.org/10.53347/rID-24686
rID:
24686
Article created:
Disclosures:
At the time the article was created Henry Knipe had no recorded disclosures.
View Henry Knipe's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.
View Arlene Campos's current disclosures
Revisions:
17 times, by
11 contributors -
see full revision history and disclosures
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Synonyms:
- TFCC
- Triangular fibrocartilage complex (TFCC)
The triangular fibrocartilage complex (TFCC) is a complex structure that is a major contributor to the stability of the wrist.
On this page:
Gross anatomy
The TFCC is located on the ulnar aspect of the wrist joint between the ulna and the lunate and triquetrum of the proximal carpal row. It has an elongated triangular shape with the apex pointing at the radius 5.
The complex is formed by multiple ligamentous and fibrocartilaginous components, including 1,2:
triangular fibrocartilage disc proper and triangular ligament
-
radioulnar ligaments:
-
ulnocarpal ligaments:
ulnar collateral ligament and extensor carpi ulnaris tendon sheath
Blood supply
central and radial portions of the TFCC are avascular
Variant anatomy
The shape of the TFCC varies with negative and positive ulnar variance 4:
negative ulnar variance: thicker, shorter with a more horizontal lie
positive ulnar variance: thinner and arc-shaped
Function
The triangular fibrocartilage complex has the following functions 3:
main stabilizer of distal radioulnar joint (DRUJ)
buttress to support the proximal carpal row
allowing for transmission of a portion of the axial load from the carpus to the ulna (~20% of the force, with the remaining 80% through the radiocarpal joint)
Related pathology
Quiz questions
References
- 1. Paul Butler, Adam Mitchell, Jeremiah C. Healy et al. Applied Radiological Anatomy. (2012) ISBN: 9780521766661 - Google Books
- 2. Burns J, Tanaka T, Ueno T, Nakamura T, Yoshioka H. Pitfalls That May Mimic Injuries of the Triangular Fibrocartilage and Proximal Intrinsic Wrist Ligaments at MR Imaging. Radiographics. 2011;31(1):63-78. doi:10.1148/rg.311105114 - Pubmed
- 3. Oneson S, Scales L, Timins M, Erickson S, Chamoy L. MR Imaging Interpretation of the Palmer Classification of Triangular Fibrocartilage Complex Lesions. Radiographics. 1996;16(1):97-106. doi:10.1148/radiographics.16.1.97 - Pubmed
- 4. Christine B. Chung, Lynne S. Steinbach. MRI of the Upper Extremity. (2010) ISBN: 9780781753135 - Google Books
- 5. Terry R. Yochum, Lindsay J. Rowe. Essentials of Skeletal Radiology. (2005) ISBN: 9780781739467 - Google Books
- 6. Taljanovic MS, Goldberg MR, Sheppard JE et-al. US of the intrinsic and extrinsic wrist ligaments and triangular fibrocartilage complex-normal anatomy and imaging technique. Radiographics. 2011;31 (1): e44. doi:10.1148/rg.e44 - Pubmed citation
- 7. Moritomo H. Anatomy and Clinical Relevance of the Ulnocarpal Ligament. J Wrist Surg. 2013;2(2):186-9. doi:10.1055/s-0033-1345023 - Pubmed
Incoming Links
Articles:
- Distal radioulnar joint
- Positive ulnar variance
- Dorsal radioulnar ligament
- Wrist
- Ulnolunate ligament
- Calcium pyrophosphate dihydrate deposition disease
- Accessory ossicles of the wrist
- Lunate
- Ulnar collateral ligament of the wrist
- Lunula
- Triangular fibrocartilage complex injury
- Wrist ligaments
- MRI of the wrist (an approach)
- Distal radioulnar joint instability
- Extensor carpi ulnaris tendinopathy
- CT hand and wrist (protocol)
- Triangular ligament
- Triquetrum
- Mucoid degeneration of the triangular fibrocartilage complex
- Distal radioulnar joint osteoarthritis
Cases:
- TFCC tear
- Triangular fibrocartilage complex displaced tear
- Ulnar styloid impaction syndrome
- Normal left wrist MRI
- Kienböck disease
- Triangular fibrocartilage complex injury - Palmer 1a
- Triangular fibrocartilage complex (Gray's illustration)
- Central triangular fibrocartilage perforation
- Triangular fibrocartilage complex tear
- Ulnar impaction syndrome
- Triangular fibrocartilage complex (TFCC) tear
- Scapholunate advanced collapse (SLAC) and dorsal intercalated segmental instability (DISI)
- TFCC disc injury and UCCL complete tear (wrist MRI arthrogram)
- Post traumatic ganglion cyst
- TFCC tear Palmer 1a
- Ulnar styloid process fracture and triangular fibrocartilage complex tear
- Triangular fibro-cartilage complex injury
- Triangular fibrocartilagenous complex tear
- Triangular fibrocartilage complex tear with scapholunate advanced collapse and dorsal intercalated segment instability
- Ulnomeniscal homologue (diagram)
Multiple choice questions:
Related articles: Anatomy: Upper limb
-
skeleton of the upper limb
- clavicle
- scapula
- humerus
- radius
- ulna
- hand
- accessory ossicles of the upper limb
- accessory ossicles of the shoulder
- accessory ossicles of the elbow
-
accessory ossicles of the wrist (mnemonic)
- os centrale carpi
- os epilunate
- os epitriquetrum
- os styloideum
- os hamuli proprium
- lunula
- os triangulare
- trapezium secondarium
- os paratrapezium
- os radiostyloideum (persistent radial styloid)
- joints of the upper limb
-
pectoral girdle
-
shoulder joint
- articulations
- associated structures
- joint capsule
- bursae
- ligaments
- movements
- scapulothoracic joint
-
glenohumeral joint
- arm flexion
- arm extension
- arm abduction
- arm adduction
- arm internal rotation (medial rotation)
- arm external rotation (lateral rotation)
- circumduction
- arterial supply - scapular anastomosis
- ossification centers
-
shoulder joint
-
elbow joint
- proximal radioulnar joint
- ligaments
- associated structures
- movements
- alignment
- arterial supply - elbow anastomosis
- development
-
wrist joint
- articulations
-
ligaments
- intrinsic ligaments
- extrinsic ligaments
- radioscaphoid ligament
- dorsal intercarpal ligament
- dorsal radiotriquetral ligament
- dorsal radioulnar ligament
- volar radioulnar ligament
- radioscaphocapitate ligament
- long radiolunate ligament
- Vickers ligament
- short radiolunate ligament
- ulnolunate ligament
- ulnotriquetral ligament
- ulnocapitate ligament
- ulnar collateral ligament
- associated structures
- extensor retinaculum
- flexor retinaculum
- joint capsule
- movements
- alignment
- ossification centers
-
hand joints
- articulations
- carpometacarpal joint
-
metacarpophalangeal joints
- palmar ligament (plate)
- collateral ligament
-
interphalangeal joints
- palmar ligament (plate)
- collateral ligament
- movements
- ossification centers
- articulations
-
pectoral girdle
- spaces of the upper limb
- muscles of the upper limb
- shoulder girdle
- anterior compartment of the arm
- posterior compartment of the arm
-
anterior compartment of the forearm
- superficial
- intermediate
- deep
-
posterior compartment of the forearm (extensors)
- superficial
- deep
- muscles of the hand
-
accessory muscles
- elbow
- volar wrist midline
- palmaris longus profundus
- aberrant palmaris longus
- volar wrist radial-side
- accessory flexor digitorum superficialis indicis
- flexor indicis profundus
- flexor carpi radialis vel profundus
- accessory head of the flexor pollicis longus (Gantzer muscle, common)
- volar wrist ulnar-side
- dorsal wrist
- blood supply to the upper limb
-
arteries
- subclavian artery (mnemonic)
- axillary artery
- brachial artery (proximal portion)
- ulnar artery
- radial artery
- veins
-
arteries
- innervation of the upper limb
- intercostobrachial nerve
-
brachial plexus (mnemonic)
- branches from the roots
- branches from the trunks
- branches from the cords
- lateral cord
- posterior cord
- medial cord
- terminal branches
- lymphatic drainage of the upper limb
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