The Orthobullets Podcast Hand⎪TFCC Injury
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Dec 27, 2023 Explore the intricate world of TFCC injuries, from how they occur to their anatomical complexities. Discover the differences between traumatic and degenerative tears, and which imaging techniques can provide clarity. Learn about management options, including cutting-edge surgical techniques like arthroscopic repair and the wafer procedure. Delve into biomechanics and the importance of the DRUJ stabilizers. Plus, get insights through case questions that clarify treatment principles for common complications.
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TFCC Anatomy: Deep Versus Superficial Fibers
- The TFCC includes dorsal/volar radioulnar ligaments, a central disc, ECU subsheath, and meniscal homologue.
- Deep fibers attach to the ulnar fovea while superficial fibers attach to the ulnar styloid.
Classify TFCC Tears With Palmer System
- Palmer classification separates traumatic (Class 1) and degenerative (Class 2) TFCC tears with subtypes.
- Central tears, ulnar avulsions, distal avulsions, and radial avulsions map to 1A–1D.
Use The Fovea Sign And Provocative Tests
- Use the fovea sign to screen for TFCC foveal disruptions; it has high sensitivity and specificity.
- Elicit pain with ulnar deviation (compression) and radial deviation (tension) to localize the lesion.