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三角纤维软骨复合体损伤

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TFCC injuries — pain on the ulnar side of the wrist, often with clicking, and treatment options.

Updated Aug 2026
一幅手绘插图，展示手腕在俯卧撑姿势下受力，小指侧出现疼痛。
三角纤维软骨复合体（TFCC），位于手腕的小指侧。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能会感到手腕外侧、靠近小指根部区域疼痛。该区域正是三角纤维软骨复合体（TFCC）所在的位置。TFCC 是由韧带和软骨组成的一组结构，充当腕关节的减震器和稳定器。当该结构受损时，您可能会感到钝痛或锐痛，且在活动时加重。

当您扭转手腕或用手承重时，疼痛往往会加剧。简单的日常活动可能会变得困难。您在转动门把手、打开罐子或使用螺丝刀时可能会感到不适。提举物体，尤其是掌心向下时，可能会引发锐痛。将手伸到背后扣内衣或把衬衫塞进裤子里也可能牵拉受伤区域。您可能会发现自己避免用那只手进行提举重物或从椅子上撑起等活动。

有些人注意到夜间疼痛加重，特别是如果您侧卧睡觉并对腕部施加压力时。另一些人则在早晨刚醒来时感到僵硬。休息后不适感可能会缓解，但在活动后会再次出现。您在旋转前臂时可能会感到咔哒声或卡顿感。这是因为受损的组织在关节内不再平滑滑动。

按压手腕外侧时，出现肿胀或压痛是很常见的。疼痛可能会放射至前臂上方或手指下方。您可能会感觉腕关节不稳定或无力，仿佛在某些动作中会突然无力。这些症状会使日常活动变得令人沮丧和疲惫。了解这些感觉有助于您保护腕关节并寻求正确的治疗。您的外科医生将利用这些信息来指导您的治疗方案。

实际发生了什么

您的手腕是一个由小骨头和软组织组成的复杂铰链结构，它们协同工作，使您能够旋转手掌并承受重量。在这个关节的边缘，存在着三角纤维软骨复合体（TFCC）。可以将其想象成一个减震垫片或橡胶垫圈。它位于前臂骨和腕骨之间，在运动过程中提供稳定性和缓冲作用。

当该区域受伤时，这个“垫片”可能会撕裂或磨损。这通常发生在摔倒时手掌撑地或反复进行扭转动作之后。撕裂破坏了关节的光滑表面。骨头不再自由滑动，而是可能相互摩擦或卡在撕裂的组织上。这就是为什么您在旋转前臂或从椅子上撑起时会感到疼痛的原因。

这种损伤也会影响周围的结构。作为固定所有结构的“套筒”的关节囊可能会发炎或拉伸。您可能还伴有附近稳定韧带（如背侧桡腕韧带）的撕裂。这些韧带像绳索一样保持骨头排列整齐。当它们与 TFCC 同时受损时，您的手腕会感到不稳定或无力。

有时，疼痛源于附近神经的刺激。例如，骨间后神经靠近常见的手术入路点。如果该神经受到刺激，可能会引起刺痛或烧灼感。然而，您的大多数症状源于机械性问题：缓冲垫缺失，关节面滑动不正确。

您的外科医生使用一种称为关节镜的小型摄像头来观察关节内部。该工具可以提供清晰的损伤视图。它不仅有助于识别 TFCC 撕裂，还能发现任何可能导致您疼痛的其他软组织损伤。通过确切了解问题所在，我们可以制定正确的治疗方案，以恢复稳定性并减轻您的不适。

我们能做什么

本诊所对您三角纤维软骨复合体（TFCC）损伤的处理方案，反映了 Mater Private Hospital Rockhampton 上肢外科医生 Kieran Hirpara 医生对该疾病的管理方式。我们为您指引一条清晰的诊疗路径，从创伤最小的选项开始，仅在必要时才进行手术。患者由全科医生或物理治疗师转诊至本诊所。通过诊所评估（包括病史采集、体格检查以及必要的影像学检查）确立诊断。对于退行性或长期存在的问题，我们通常首先尝试非手术治疗。对于结构性或急性问题，则可能建议立即手术。

您可以从改变手腕的使用方式开始，以避免引起疼痛的动作。休息关节并使用夹板有助于减少刺激。物理治疗旨在恢复您手腕和手部的力量与灵活性。这一过程需要时间，因此我们要求在考虑其他步骤之前，先对保守治疗进行充分的尝试。

如果疼痛持续存在，我们可能会讨论药物治疗方案。止痛药和抗炎药有助于控制症状。注射治疗（如皮质类固醇）可减少炎症并提供有限时间的缓解。其他选项如透明质酸或富血小板血浆（PRP）有时用于支持愈合，但疗效持续时间各不相同。我们会与您讨论这些选项，以确定最适合您情况的治疗方案。

当保守治疗未能带来足够改善，或您的损伤为急性时，我们会考虑手术。腕关节镜是诊断和治疗 TFCC 病变的关键工具。它使我们能够清晰地观察关节内部，并以微创方式修复损伤。接受腕关节镜检查以治疗持续性腕痛的患者，在一年时平均改善约 50%。然而，大多数患者在一年后仍会残留一些疼痛和功能障碍。我们如实呈现这些数据，以便您参与共同决策，制定您的治疗方案。

预期情况

腕关节镜手术是一项安全的手术，通过小型摄像头观察腕关节内部。它有助于您的外科医生诊断和治疗三角纤维软骨复合体（TFCC）损伤等问题。大多数患者会出现轻微且暂时的副作用。这些副作用通常很快消退。然而，并发症的真实发生率可能高于以往认为的水平。神经刺激是常规手术中可能发生的一种风险。

如果您有持续的腕部疼痛，您会期望症状逐渐改善。平均而言，患者在术后一年时症状改善约 50%。这意味着您的疼痛和残疾程度可能会降至治疗前的一半左右。您将注意到腕部的感觉和功能有所变化。

保持现实的期望非常重要。大多数接受该手术的患者在术后一年仍会经历一些疼痛和功能障碍。中度不适感通常会持续存在。您可能无法恢复到之前 100% 的功能水平。目标是显著缓解症状，而非 necessarily 彻底治愈。

如果通过这种方法能很好地控制您的病情，您可能会在第一年内看到稳步进展。如果不予干预，持续的腕部疼痛往往会持续存在，而不会出现这种结构化的改善。该手术是评估和治疗这些棘手腕部疾病的重要工具。

最近的技术进步使得治疗更加精准。您的外科医生将使用专用器械检查关节面和软组织。这有助于识别可能导致您症状的其他损伤。该手术属于微创手术，与开放手术相比，其恢复过程更为安全。

您应做好适应期的准备。虽然手术本身很快，但愈合过程需要时间。当您开始再次活动腕部时，可能会感到一些僵硬和酸痛。定期随访您的外科医生对于监测您的进展至关重要。他们将指导您何时可以安全地增加活动量。

信任治疗过程。改善是以月为单位衡量的，而不是以天为单位。到术后一年时，您应对长期预后有更清晰的了解。大多数患者认为，疼痛的减轻值得付出的康复努力。您将与您医疗团队共同努力，管理任何残留症状。这种合作关系有助于您获得腕部的最佳治疗效果。

何时就诊

如果您有持续不缓解的腕部疼痛，即使休息后仍无改善，请寻求专科医生评估。如果出现无力、不稳感、卡顿感或关节突然失稳感，请及时就医。如果症状干扰您的睡眠或工作，或疼痛突然加重，请联系您的医生。腕关节镜是诊断这些问题的关键工具。尽管许多患者在一年内疼痛和功能障碍可改善约50%，但多数人仍会残留一定程度的不适。早期评估有助于您的外科医生判断该手术是否适合您。

Reviewed by Dr Kieran Hirpara · 10 June 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Surgical treatment of TFCC tears and concomitant pathology in the pediatric and adolescent population results in decreased pain, improved motion and stability, and excellent functional outcomes in the majority of patients [1].
  • Acute TFCC injuries require differentiation between those causing distal radioulnar joint (DRUJ) instability and those that do not [2].
  • Management of acute TFCC injuries ranges from nonsurgical immobilization to arthroscopic or open surgical repair depending on the specific injury pattern and stability [2].
  • About 40% of patients sustaining a TFCC tear without DRUJ instability still had pain and disability at 1 year [3].
  • Arthroscopic-assisted repair techniques provide detailed visualization and facilitate the repair of TFCC injuries and associated pathologies with minimally invasive techniques [5, 6].
  • Arthroscopic treatment of TFCC lesions leads to satisfactory functional outcomes [7].
  • TFCC repair achieves good clinical outcomes with low complication rates [11].
  • There was no statistical difference in clinical outcomes after open versus arthroscopic TFCC repair [12].
  • There is a current lack of high-quality evidence required to draw firm conclusions on the merits of arthroscopic versus open repair of 1B TFCC tears [19].
  • In high-demand athletes, arthroscopic repair of TFCC tears is becoming the treatment of choice to obtain optimum physiologic strength, complete range of motion, stability, and the shortest possible postoperative period [25].
  • TFCC repair varies substantially from surgeon-to-surgeon, suggesting repairs are discretionary and preference sensitive [27].

Anatomy & Pathophysiology

  • The triangular fibrocartilage complex (TFCC) is a key anatomical structure involved in ulnar-sided wrist pain, alongside distal radioulnar joint (DRUJ) disorders and extensor carpi ulnaris (ECU) tendon disorders [16].
  • Ulnar-sided wrist pain often results from a combination of overuse and acute injury, requiring an understanding of sport-specific injuries and underlying biomechanics for effective diagnosis [32].
  • Determining the etiology of ulnar-sided wrist pain is challenging due to overlapping history and physical examination findings [38].
  • A systematic approach to evaluating patients with ulnar-sided wrist pain is imperative [42].
  • Distal radioulnar joint instability is often an underestimated lesion requiring systematic clinical examination and imaging for detection [35].
  • Deep TFCC fiber tears may contribute to decreased wrist rotational positioning sense [30].
  • Deep TFCC fiber tears may have biomechanical importance in distal radioulnar joint stability [30].
  • The intensity of pain produced by stressing the wrist in different positions differs between traumatic tears and degenerative wear [41].
  • Distal radius fractures are common pediatric injuries with significant remodeling potential depending on age and deformity direction [36].
  • Associated ulnar styloid fractures and significant radial translation are predictors of distal radioulnar joint instability in the context of distal radius fractures [48].
  • Statistical analysis did not identify a correlation between any single radiographic parameter of distal radius fractures and associated triangular fibrocartilage complex injuries [45].
  • Load-bearing radioulnar measurement is a simple method to diagnose an unstable distal radioulnar joint in patients with TFCC injury [18].
  • Dynamic CT imaging shows promise for evaluating the distal radioulnar joint during wrist motion [33].
  • When the appropriate pulse sequence is used, magnetic resonance imaging is an accurate and effective method for the non-invasive evaluation of wrist pain [44].

Classification

  • TFCC injuries are differentiated based on whether they cause distal radioulnar joint (DRUJ) instability [2].
  • About 40% of patients with a TFCC tear without DRUJ instability still had pain and disability at 1 year [3].
  • Type 1B TFCC injury is the most common TFCC injury in patients with distal radius fractures (DRF) [8].
  • The presence of an ulnar styloid fracture associated with a distal radius fracture predicts the presence of traumatic TFCC injury, specifically TFCC type 1B injury [10].
  • Frykman Type VI and VIII distal radius fractures show a significantly higher incidence of TFCC tears [34].
  • The Melone classification system does not predict the presence of TFCC lesions after distal radius fractures [34].
  • Classification of central TFCC lesions as traumatic or degenerative depends on information provided upon viewing the lesion at arthroscopy [13].
  • Atzei's classification is used for the detailed classification of pc-TFCC tears [21].
  • The diagnostic accuracy of MRI for detailed TFCC classifications, such as Atzei's classification, is lower compared to wrist arthroscopy [21].
  • A treatment-oriented classification system categorizes five classes of TFCC peripheral tears based on clinical and arthroscopic criteria [28].
  • Coexisting type 2 TFCC tears significantly increase the risk of index surgery failure in patients undergoing arthroscopic repair of peripheral ulnar-side TFCC tears [14].

Clinical Presentation

  • Careful history and physical examination are required to determine whether a TFCC tear is symptomatic [9].
  • It is important to quantify the severity of symptoms related to TFCC pathology to determine whether surgical treatment is necessary [9].
  • Disability outcomes were worse in patients with distal radial fractures where the TFCC was injured [20].
  • The 1B TFCC injury is the most common type in patients with distal radius fractures (DRF) and concomitant TFCC injury [8].
  • The presence of an ulnar styloid fracture associated with a distal radius fracture predicts the presence of traumatic TFCC injury, specifically TFCC 1B injury [10].
  • Classification of central triangular fibrocartilage complex lesions as traumatic or degenerative depends on the information provided upon viewing the lesion at arthroscopy [13].
  • Arthroscopy is effective in obtaining both correct diagnosis and treatment of peripheral TFCC tears [15].
  • MR arthrography is a more sensitive and specific method for the diagnosis of TFCC tears compared to conventional wrist MRI [22].
  • Load-bearing radioulnar (RaUl) measurement is a simple method to diagnose an unstable distal radioulnar joint in patients with TFCC injury [18].
  • Ulnar-sided contrast leakage is more common in patients with peripheral TFCC injuries, requiring distinction from atypical configuration of the prestyloid recess in CT arthrography [24].
  • There is a higher frequency of accompanying extensor carpi ulnaris (ECU) tendon and/or DRUJ disorders in patients with chronic TFCC tears compared to controls [23].
  • Damage to the TFCC itself may alter relationships of the DRUJ and the ECU subsheath, or various pathologies causing ulnar-sided wrist pain may drive patients toward surgery [17].

Investigations

  • Radiocarpal arthrograms were better at detecting TFCC tears than midcarpal arthrograms [47].
  • Midcarpal arthrograms were best for detecting lunotriquetral (LT) tears [47].
  • Arthroscopy remains the gold standard for diagnosis [47].
  • Arthroscopy is effective in obtaining both correct diagnosis and treatment of peripheral TFCC tear [15].
  • CT arthrography and MR arthrography have statistically equivalent sensitivity and specificity for the diagnosis of TFCC injuries [53].
  • The sensitivity, specificity, and accuracy of 3.0T wrist MRI for the TFCC are consistently higher compared with those of 1.5T wrist MRI [43].
  • In detailed classification of TFCC injuries, such as pc-TFCC tears classified by Atzei's classification, the diagnostic accuracy of MRI remains lower compared to wrist arthroscopy [21].
  • Ulnar-sided contrast leakage is more common in patients with peripheral TFCC injuries on CT arthrography [24].
  • Distinction between an atypical configuration of the prestyloid recess and actual leakage is important in CT arthrography of the wrist [24].
  • The presence of an ulnar styloid fracture associated with distal radius fracture predicts the presence of frequently occurring traumatic TFCC injury and TFCC 1B injury [10].
  • TFCC 1B injury is the most common type in patients with distal radius fractures (DRF) and concomitant TFCC injury [8].
  • There is a high incidence of TFCC abnormalities on MRI in asymptomatic subjects, particularly those over the age of 50 [51].
  • The presence of an abnormal TFCC on MRI may be of questionable clinical meaning due to the high incidence of abnormalities in asymptomatic subjects [51].

Treatment

Non-Operative Management

  • Nonsurgical treatment is moderately successful for treating patients with TFCC tears without distal radioulnar joint (DRUJ) instability [31].
  • Nonoperative management of traumatic TFCC injuries with above-elbow immobilization is a viable treatment method, particularly in patients without DRUJ subluxation [46].

Operative Management: Indications and Selection

  • Acute TFCC injuries require differentiation between those causing DRUJ instability and those that do not, with management ranging from nonsurgical immobilization to arthroscopic or open surgical repair depending on the specific injury pattern and stability [2].
  • Careful history and physical examination are required to determine whether a TFCC tear is symptomatic, and it is important to quantify the severity of symptoms related to TFCC pathology to determine whether surgical treatment is necessary [9].

Operative Management: Surgical Techniques and Approaches

  • Arthroscopic-assisted repair techniques have revolutionized surgical management, providing detailed visualization and facilitating the repair of TFCC injuries and associated pathologies with minimally invasive techniques [5].
  • Open and arthroscopic techniques are available for TFCC injuries [4].

Operative Management: Outcomes by Technique

  • Current evidence demonstrates that TFCC repair achieves good clinical outcomes, with low complication rates [11].
  • A systematic review demonstrates a current lack of high-quality evidence required to draw firm conclusions on the merits of arthroscopic versus open repair of 1B TFCC tears [19].

Operative Management: Specific Populations and Pathologies

  • Arthroscopic debridement alone appears to be an effective and safe initial treatment for patients with traumatic central TFCC tears [29].
  • Coexisting type 2 TFCC tears significantly increased the risk of index surgery failure in patients with peripheral ulnar-side TFCC tears [14].
  • The combined extensor retinaculum capsulorrhaphy and suture repair effectively restores stability to both the DRUJ and ulnocarpal joint (UCJ) in patients with TFCC-related ulnocarpal instability, considerably reducing pain and preserving range of motion [37].

Complications

  • Approximately 40% of patients sustaining a TFCC tear without distal radioulnar joint instability (DRUJ) instability still had pain and disability at 1 year [3].
  • Coexisting type 2 TFCC tears significantly increased the risk of index surgery failure in patients undergoing arthroscopic repair of peripheral ulnar-sided TFCC tears [14].

Recovery

  • TFCC capsular reattachment performed with an arthroscopically assisted technique provides good long-term results [26].
  • Disability outcomes were worse in patients with distal radial fracture where TFCC was injured [20, 52].
  • In the first year after open TFCC reinsertion, 91% of patients returned to work, including 50% within 12 weeks [54].
  • About 40% of patients sustaining TFCC tear without distal radioulnar joint instability still had pain and disability at 1 year [3].

Key Evidence

  • [L4] Surgical treatment of TFCC tears and concomitant pathology in the pediatric and adolescent population results in decreased pain, improved motion and stability, and excellent functional outcomes in the majority of patients. [1] (10.1016/j.jhsa.2019.06.019)
  • [L5] Acute TFCC injuries require differentiation between those causing distal radioulnar joint instability and those that do not, with management ranging from nonsurgical immobilization to arthroscopic or open surgical repair depending on the specific injury pattern and stability. [2] (10.5435/00124635-200806000-00004)
  • [L4] About 40% of patients sustaining TFCC tear without DRUJ instability still had pain and disability at 1 year. [3] (10.1016/j.jhsa.2018.06.064)
  • [L5] The article reviews diagnosis, classification, and treatment options including open and arthroscopic techniques for TFCC injuries. [4] (10.1016/j.hcl.2010.07.003)
  • [L5] Arthroscopic-assisted repair techniques have revolutionized surgical management, providing detailed visualization and facilitating the repair of TFCC injuries and associated pathologies with minimally invasive techniques. [5] (10.1016/j.jhsg.2025.100857)
  • [L5] Arthroscopic-assisted repair techniques have revolutionized surgical management, providing detailed visualization and facilitating the repair of TFCC injuries and associated pathologies with minimally invasive techniques. [6] (10.1016/j.jhsg.2024.03.011)
  • [L4] Arthroscopic treatment of TFCC lesions leads to satisfactory functional outcomes. [7] (10.1055/s-0039-3400454)
  • [L3] 1B TFCC injury is most common in patients with DRF and concomitant TFCC injury. [8] (10.1186/s13018-023-04438-5)
  • [L4] Careful history and physical examination are required to determine whether a TFCC tear is symptomatic, and it is important to quantify the severity of symptoms related to TFCC pathology to determine whether surgical treatment is necessary. [9] (10.5435/jaaos-d-20-00998)
  • [L4] The presence of ulnar styloid fracture associated with distal radius fracture predicted the presence of frequently occurring traumatic triangular fibrocartilage complex injury and TFCC 1B injury. [10] (10.1016/j.arthro.2020.05.025)
  • [L4] Current evidence demonstrates that TFCC repair achieves good clinical outcomes, with low complication rates. [11] (10.1055/s-0040-1718913)
  • [L3] There was no statistical difference in clinical outcomes after open versus arthroscopic TFCC repair. [12] (10.1016/j.jhsa.2008.01.020)
  • [L2] Classification of central triangular fibrocartilage complex lesions as traumatic or degenerative depends on the information provided upon viewing the lesion at arthroscopy. [13] (10.1177/1753193416684658)
  • [L4] However, coexisting type 2 TFCC tears significantly increased the risk of index surgery failure in these patients. [14] (10.1016/j.arthro.2020.05.012)
  • [L4] Arthroscopy is effective in obtaining both correct diagnosis and treatment of peripheral TFCC tear. [15] (10.2174/1874325001711010525)
  • [L5] The article provides a concise approach to the diagnosis and imaging of ulnar-sided wrist pain, discussing anatomy, pathophysiology, and radiographic appearance of common entities including TFCC tears, DRUJ disorders, and ECU tendon disorders. [16] (10.1016/j.csm.2006.02.008)
  • [L3] This may be due to the damage to the TFCC itself altering relationships of the DRUJ and the ECU subsheath, or it may reflect various pathologies that cause ulnar-sided wrist pain and drive patients toward surgery. [17] (10.1177/1558944720937369)
  • [L2] Load-bearing RaUl measurement is a simple method to diagnose an unstable distal radioulnar joint in patients with TFCC injury. [18] (10.1016/j.jhsa.2022.01.008)
  • [L4] This SR demonstrates a current lack of high-quality evidence required to draw firm conclusions on the merits of arthroscopic versus open repair of 1B TFCC tears. [19] (10.1177/1558944718815244)
  • [L2] Disability outcomes were worse in patients with distal radial fracture where TFCC was injured. [20] (10.1016/j.jht.2017.09.002)
  • [L4] In more detailed classification of TFCC injuries, such as pc-TFCC tears classified by Atzei's classification, the diagnostic accuracy of MRI remains lower compared to wrist arthroscopy. [21] (10.1186/s12891-023-07140-z)
  • [L3] MR arthrography is more sensitive and specific method in terms of the diagnosis of TFCC tears compared to conventional wrist MRI. [22] (10.1016/j.injury.2019.07.032)
  • [L3] We found a higher frequency of accompanying ECU tendon and/or DRUJ disorders in patients with chronic TFCC tears as compared to the control group. [23] (10.1016/j.jhsa.2016.07.040)
  • [L4] Since ulnar-sided contrast leakage is more common in patients with peripheral TFCC injuries, distinction between an atypical configuration of the prestyloid recess and actual leakage is important in CT arthrography of the wrist. [24] (10.1186/s12891-022-05241-9)
  • [L4] In high-demand athletes, arthroscopic repair of TFCC tears is becoming the treatment of choice to obtain optimum physiologic strength, complete range of motion, stability, and the shortest possible postoperative period. [25] (10.1016/j.hcl.2009.05.011)
  • [L5] TFCC capsular reattachment could be performed with an arthroscopically assisted technique, providing good long-term results. [26] (10.1016/j.hcl.2017.06.005)
  • [L4] TFCC repair varies substantially from surgeon-to-surgeon, suggesting repairs are discretionary and preference sensitive. [27] (10.1055/s-0038-1625953)
  • [L2] The classification highlights clinical and arthroscopic criteria to categorize five classes of TFCC peripheral tears on a treatment-oriented system. [28] (10.1177/1753193416687479)
  • [L3] Arthroscopic debridement alone appears to be an effective and safe initial treatment for patients with traumatic central TFCC tears. [29] (10.1302/0301-620x.106b4.bjj-2023-0642.r3)
  • [L3] Deep TFCC fiber tear may contribute to decreased wrist rotational positioning sense and may have biomechanical importance in distal radioulnar joint stability. [30] (10.1016/j.jhsa.2018.01.022)
  • [L3] Nonsurgical treatment is moderately successful for treating patients with TFCC tears without DRUJ instability. [31] (10.1097/corr.0000000000000533)
  • [L5] Ulnar-sided wrist pain in athletes is a common problem often resulting from a combination of overuse and acute injury, requiring careful understanding of sport-specific injuries and underlying biomechanics for effective diagnosis and treatment. [32] (10.1016/j.csm.2019.12.008)
  • [L4] Dynamic CT imaging shows promise for evaluating the distal radioulnar joint during wrist motion. [33] (10.1177/17531934251397297)
  • [L3] The Melone classification system does not predict the presence of TFCC lesions, while Frykman Type VI and VIII fractures show a significantly higher incidence of TFCC tears. [34] (10.1177/1753193408090106)
  • [L5] Distal radioulnar joint instability is often an underestimated lesion requiring systematic clinical examination and imaging for detection. [35] (10.1007/s00402-020-03371-0)
  • [L5] Distal radius fractures are common pediatric injuries with significant remodeling potential depending on age and deformity direction. [36] (10.1016/j.hcl.2005.09.002)
  • [L4] The combined HS and suture repair effectively restores stability to both the DRUJ and UCJ in patients with TFCC-related ulnocarpal instability, considerably reducing pain and preserving range of motion. [37] (10.1016/j.jhsg.2025.100806)
  • [L5] Determining the etiology of ulnar-sided wrist pain is often challenging due to overlapping history and physical examination findings; a detailed history, systematic physical examination with provocative maneuvers, and appropriate diagnostic imaging are essential for diagnosis. [38] (10.5435/jaaos-d-16-00407)
  • [L3] The intensity of pain produced by stressing the wrist in different positions was different between a traumatic tear and degenerative wear. [41] (10.1177/1753193410377838)
  • [L4] A systematic approach to evaluating patients with ulnar-sided wrist pain is imperative. [42] (10.1016/j.jhsa.2014.07.004)
  • [L3] The sensitivity, specificity, and accuracy of 3.0T wrist MRI for the TFCC is consistently higher compared with those of 1.5T wrist MRI, suggesting improved capability for detection of TFCC injuries. [43] (10.1016/j.jhsa.2008.02.028)
  • [L2] When the appropriate pulse sequence is used, magnetic resonance imaging is an accurate and effective method for the non-invasive evaluation of pain in the wrist. [44] (10.2106/00004623-199711000-00009)
  • [L3] Statistical analysis did not identify a correlation with any single radiographic parameter of the distal radius fractures with the associated triangular fibrocartilage complex injuries. [45] (10.1177/1753193415624669)
  • [L3] Nonoperative management of traumatic TFCC injuries with above-elbow immobilization is a viable treatment method, particularly in patients without DRUJ subluxation. [46] (10.1302/0301-620x.103b8.bjj-2020-2310.r2)
  • [L4] Radiocarpal arthrograms were better at detecting TFCC tears and midcarpal arthrograms were best for detecting LT tears, with arthroscopy remaining the gold standard. [47] (10.1016/j.arthro.2020.12.108)
  • [L3] Associated ulnar styloid fractures and significant radial translation are predictors of DRUJ instability. [48] (10.1055/s-0034-1365825)
  • [L3] The presence of an abnormal TFCC on MRI may be of questionable clinical meaning, because there is a high incidence of TFCC abnormalities in asymptomatic subjects, particularly those over the age of 50. [51] (10.1016/j.jhsa.2011.10.006)
  • [L2] Disability outcomes were worse in patients with distal radius fracture where TFCC was injured. [52] (10.1016/j.jht.2017.09.012)
  • [L1] CTA and MRA had statistically equivalent sensitivity and specificity for the diagnosis of TFCC injuries. [53] (10.1055/s-0038-1629911)
  • [L3] In the first year after open TFCC reinsertion, 91% of the patients returned to work, including 50% within 12 weeks. [54] (10.1016/j.hansur.2021.03.012)

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[10] The Presence and the Location of an Ulnar Styloid Fracture Associated With Distal Radius Fracture Predict the Presence of Triangular Fibrocartilage Complex 1B Injury. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2020. DOI: 10.1016/j.arthro.2020.05.025

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[19] Open Versus Arthroscopic Repair of 1B Ulnar-Sided Triangular Fibrocartilage Complex Tears: A Systematic Review. HAND. 2019. DOI: 10.1177/1558944718815244

[20] Outcomes of surgically treated distal radial fractures with associated triangular fibrocartilage complex injury. Journal of Hand Therapy. 2019. DOI: 10.1016/j.jht.2017.09.002

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[22] Comparison between conventional MRI and MR arthrography in the diagnosis of triangular fibrocartilage tears and correlation with arthroscopic findings. Injury. 2019. DOI: 10.1016/j.injury.2019.07.032

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[24] Evaluation of prestyloid recess morphology and ulnar-sided contrast leakage in CT arthrography of the wrist. BMC Musculoskeletal Disorders. 2022. DOI: 10.1186/s12891-022-05241-9

[25] Repair of Arthroscopic Triangular Fibrocartilage Complex Tears in Athletes. Hand Clinics. 2009. DOI: 10.1016/j.hcl.2009.05.011

[26] Arthroscopic Management of Triangular Fibrocartilage Complex Peripheral Injury. Hand Clinics. 2017. DOI: 10.1016/j.hcl.2017.06.005

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[36] Pediatric Distal Radius Fractures and Triangular Fibrocartilage Complex Injuries. Hand Clinics. 2006. DOI: 10.1016/j.hcl.2005.09.002

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[43] Diagnostic Comparison of 1.5 Tesla and 3.0 Tesla Preoperative MRI of the Wrist in Patients With Ulnar-Sided Wrist Pain. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2008.02.028

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