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J Wrist Surg 2024; 13(01): 002-008
DOI: 10.1055/s-0043-1769908
Special Review: Classifications of TFCC Lesions

A New Arthroscopic Classification of Triangular Fibrocartilage Complex Disorders

Guillaume Herzberg 
1   I-Trues Surgery Unit, Orthopedic Department, Clinique Parc Lyon, Lyon, France, Clinique Val Ouest, Lyon Ecully, France
,
Marion Burnier
2   I-Trues Surgery Unit, Department of Orthopedic, Institut Main Membre Supérieur, Villeurbanne, France
,
Lyliane Ly
3   Hospices Civils Lyon, Lyon, France
,
Toshiyatsu Nakamura
4   Department of Orthopedic Surgery, Minato-Ku, Tokyo, Japan
,
Francisco del Piñal
5   Serrano 58-1B 28001–Madrid, Santander, Spain
,
Andrea Atzei
6   Chirurgia Della Mano, Polso e Gomito, Microchirurgia Ricostruttiva MediLAB Sottoportico Teatro Dofin, Treviso, Italy
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Abstract

Introduction The use of wrist arthroscopy has become a prerequisite for diagnosis and treatment of triangular fibrocartilage complex (TFCC) disorders. Since Palmer's landmark paper, many new arthroscopic descriptions of TFCC tears have been published but there is no currently available updated comprehensive arthroscopic classification of TFCC lesions.

Purpose We recently described the arthroscopic anatomy of the TFCC as viewed from a 3–4 portal. Our purpose was to propose a new TFCC disorders classification based on this new arthroscopic TFCC description.

Methods We included all currently described TFCC disorders to the best of our knowledge into our arthroscopic, functional, and vascular anatomical concept. We also included patient's specific ulnar variance and distal radial ulnar joint coronal inclination as baseline treatment-oriented parameters. The fresh or chronic, reparable or nonreparable nature of some types of TFCC tears were considered as separate parameters.

Results The proposed classification includes disc “D” (degenerative or traumatic), reins “R” (traumatic), and wall “W” (traumatic) lesions. Combined lesions of those three parts of the TFCC may be easily identified. This new classification should facilitate future analysis of isolated or combined TFCC disorders whether they are degenerative and/or traumatic.

Discussion The authors present a new three-dimensional-three-part arthroscopic updated description of TFCC disorders with relevance to etiology and treatment principles.

Keywords

wrist - TFCC tears - TFCC disorders - arthroscopy - TFCC disorder classification

Ethical Review Committee Statement

Not Applicable.




Publication History

Received: 26 January 2023

Accepted: 09 May 2023

Article published online:
07 August 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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