Triangular fibrocartilage complex
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View Yoshi Yu's current disclosures- 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.
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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. Butler P, Mitchell A, Healy JC. Applied Radiological Anatomy. Cambridge University Press. (2012) ISBN:0521766664. Read it at Google Books - Find it at Amazon
- 2. Burns JE, Tanaka T, Ueno T et-al. 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 citation
- 3. Oneson SR, Scales LM, Timins ME et-al. 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 citation
- 4. MRI of the Upper Extremity. LWW. ISBN:0781753139. Read it at Google Books - Find it at Amazon
- 5. Yochum and Rowe's Essentials of skeletal radiology. LWW. ISBN:0781739462. Read it at Google Books - Find it at Amazon
- 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. (2013) Journal of wrist surgery. 2 (2): 186-9. doi:10.1055/s-0033-1345023 - Pubmed
Related articles: Anatomy: Upper limb
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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
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pectoral girdle
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shoulder joint
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- joint capsule
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- ligaments
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- scapulothoracic joint
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glenohumeral joint
- arm flexion
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- arm internal rotation (medial rotation)
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shoulder joint
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elbow joint
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- movements
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- arterial supply - elbow anastomosis
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wrist joint
- articulations
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ligaments
- intrinsic ligaments
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- radioscaphoid ligament
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- volar radioulnar ligament
- radioscaphocapitate ligament
- long radiolunate ligament
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hand joints
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metacarpophalangeal joints
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interphalangeal joints
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pectoral girdle
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anterior compartment of the forearm
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posterior compartment of the forearm (extensors)
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accessory muscles
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arteries
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arteries
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brachial plexus (mnemonic)
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- branches from the cords
- lateral cord
- posterior cord
- medial cord
- terminal branches
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