Patterns of triangular fibrocartilage complex (TFCC) injury associated with severely dorsally displaced extra-articular distal radius fractures
Scheer JH et al. – Severe displacement of an extra–articular radius fracture suggests an ulnar–sided ligament injury to the triangular fibrocartilage (TFCC). The observed lesions concur with findings in a previous cadaver study. The lesions follow a distinct pattern affecting both radioulnar as well as ulnocarpal stabilisers.
Twenty adult patients with an Arbeitsgemeinschaft fur Osteosynthesefragen (AO), type A2 or A3, distal radius fracture with an initial dorsal angulation greater than 20° were included.
Nine had a tip fracture (distal to the base) of the ulnar styloid and 11 had no such fracture.
They were all openly explored from an ulnopalmar approach and TFCC injuries were documented.
Eleven patients also underwent arthroscopy and intra-articular pathology was recorded.
All patients had TFCC lesions of varying severity, having an extensor carpi ulnaris subsheath avulsion in common.
Eighteen out of 20 also displayed deep foveal radioulnar ligament lesions, with decreasingly dorsal fibres remaining.
The extent of this foveal injury could not be appreciated by radiocarpal arthroscopy.
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