TFCC Intro

• Triangular Fibrocartilaginous Complex (TFCC):

  • major stabiliser of the distal radioulnar joint
  • Transmits load from the carpal to the ulna particularly when axially loaded (gripping and weightbearing through hand)
  • Promotes rotation and sliding movements assisting forearm supination and pronation
  • Consist of:
  • radioulnar ligaments: dorsal and palmar
  • ulnocarpal ligaments: ulnotriquetral and ulnolunate
  • ulnar collateral ligament, triangular fibrocartilage disc
  • ulna capsule
  • sheath of ECU
• Triangular Fibrocartilaginous Complex (TFCC):

  • TFCC is complex
  • injury to any part of the TFCC impairs its stability and load transfer function

  
• Triangular Fibrocartilaginous Complex (TFCC) - Clinical Presentation & Assessment:

  • ulnar sided wrist pain often with clicking/grinding
  • worse with pronation and supination activity, e.g. turning door handles, pushing up from chair
  • weakness or feeling of instability or catching
  • may have crepitus, swelling
  • pain on pronation/supination
  • possible tenderness (and swelling) of dorsal/ulnar aspect of the wrist
  • pain on resisted wrist ulnar deviation and extension (ECU)
  • reduced grip strength
• Triangular Fibrocartilaginous Complex (TFCC) - TFCC Special Tests:

  • piano key sign test
  • sensitivity: 59%
  • specificity: 96%
  • ulnar fovea test
  • sensitivity: 95.2%
  • specificity: 86.5%
  • press test
  • sensitivity: 100%
  • specificity: unknown
  • TFCC load test
• • TFCC is Triangular Fibrocartilaginous Complex