EVALUATING THE TRIANGULAR FIBROCARTILAGE COMPLEX: ANATOMICAL INSIGHTS AND CLINICAL IMPLICATIONS FOR SPORTS-RELATED WRIST INJURIES

Abstract

Objective: This study aims to elucidate the anatomical structure of the Triangular Fibrocartilage Complex (TFCC) and its implications for sports-related ulnar-sided wrist pain, which is increasingly prevalent among athletes due to modern exercise and sports activities. By providing detailed anatomical insights, the study seeks to inform more effective diagnosis and treatment strategies for TFCC injuries in the athletic population. Materials and Methods: Anatomical dissection of the TFCC was performed on seven formalin-preserved cadaveric specimens from the upper forearm to explore its structure and its relationship with adjacent anatomies. Traditional wrist arthroscopy portals were used to examine and repair TFCC injuries, facilitating a practical understanding of surgical approaches. Additionally, 23 athletes with diagnosed TFCC injuries were treated via these conventional arthroscopy portals, and the manifestations of their anatomical structures under arthroscopic examination were systematically analyzed. Results: The TFCC, situated between the ulnar head and the ulnar carpal bone, comprises several ligamentous and cartilaginous components that contribute to its complex structure. It plays a critical role in wrist stability and load transmission across the ulnocarpal joint. Surgical observations revealed that TFCC injuries such as perforations, attachment avulsions, and combined pathologies with ulnar impaction syndrome are prevalent among athletes. Various surgical interventions, including TFCC debridement, attachment reconstruction, and ulnar shortening osteotomies, were employed based on the specific nature of the injuries. Conclusion: Understanding the detailed anatomy and typical injury patterns of the TFCC is crucial for effectively managing sports-related wrist injuries. Surgical repair techniques tailored to the unique demands of athletes can lead to optimized recovery and better functional outcomes. This study underscores the importance of specialized approaches in treating TFCC injuries within sports medicine and highlights the need for ongoing research to refine surgical techniques and rehabilitation protocols tailored to the athletic population. TFCC connects with the complex ulnocarpal structure and is the key structure to stabilize the distal radioulnar joint. Patients with ulnar impaction may be more commonly associated with TFCC injury.