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. 2022 Jul;35(5):626-648.
doi: 10.1002/ca.23880. Epub 2022 Apr 16.

The triangular fibrocartilage complex in the human wrist: A scoping review toward uniform and clinically relevant terminology

Anne-Sophie van der Post  1   2   3 , Sjoerd Jens  4 , Joost G Daams  5 , Miryam C Obdeijn  2   6 , Mario Maas  1   2   3 , Roelof-Jan Oostra  7
Affiliations

The triangular fibrocartilage complex in the human wrist: A scoping review toward uniform and clinically relevant terminology

Anne-Sophie van der Post et al. Clin Anat. 2022 Jul.

Abstract

The aim of this scoping review was to assess the composition, terminology, and anatomy of the triangular fibrocartilage complex (TFCC) of the wrist and propose unambiguous terminology regarding the individual components. The review was conducted according to the methodological framework by Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19-32). Electronic databases were searched from inception until September 1, 2021 for original anatomical studies, using MeSH terms and keywords on terminology and anatomy of TFCC components. Studies using gross dissections or macro- or microscopic histology were included. Animal studies, fetal studies and studies with unknown disease status, were excluded. A total of 24 studies were included. The articular disc, the radioulnar ligaments, the meniscus homologue and the extensor carpi ulnaris tendon (sub)sheath were unanimously classified as TFCC components. One study did not include the ulnolunate and ulnotriquetral ligaments and only one study did include the ligamentum subcruentum. The largest disagreement existed regarding the inclusion of the ulnar collateral ligament. Terminological ambiguity was seen in "triangular fibrocartilage," "triangular ligament," "igamentum subcruentum," and the "proximal and distal lamina." Anatomical ambiguity existed especially regarding the radioulnar ligaments, the ulnar attachments of the TFCC and the ulnar collateral ligament. Definitions of the individual TFCC components are redundant, ambiguous, and ill-defined and therefore subject to different interpretations. In order to preclude confusion, consensus regarding terminology is recommended. We proposed a concise definition of the healthy TFCC that can be used as a starting point for future studies and current clinical practice.

Keywords: anatomy; terminology; triangular fibrocartilage complex; wrist.

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Figures

FIGURE 1
FIGURE 1
Preferred reporting items for systematic reviews and meta‐analyses for scoping reviews (PRISMA‐ScR) flow diagram of the study selection
FIGURE 2
FIGURE 2
Coronal sections thought the TFCC of a human cadaver wrist without reported wrist pain or history of wrist injury (50 um slice thickness and Mallory/Cason staining) from dorsal to volar indicating (A, B) the dorsal radioulnar ligament, (C, D) a small part of the extensor carpi ulnaris tendon sheath, (E, F) the centrally perforated articular disc, the proximal and distal lamina with the clear space in which the vascular tissue of the ligamentum subcruentum is situated in between the lamina, the meniscus homologue, (G, H) the prestyloid recess, the ulnotriquetral ligament and (I, J) the ulnolunate ligament and volar radioulnar ligament
See this image and copyright information in PMC

References

    1. Aaron, J. E. (2012). Periosteal Sharpey's fibers: A novel bone matrix regulatory system? Frontiers in Endocrinology, 3, 98. - PMC - PubMed
    1. Arksey, H. , & O'Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32.
    1. Atzei, A. , & Luchetti, R. (2011). Foveal TFCC tear classification and treatment. Hand Clinics, 27(3), 263–272. - PubMed
    1. Bednar, M. S. , Arnoczky, S. P. , & Weiland, A. J. (1991). The microvasculature of the triangular fibrocartilage complex: Its clinical significance. The Journal of Hand Surgery, 16(6), 1101–1105. - PubMed
    1. Bendre, H. H. , Oflazoglu, K. , van Leeuwen, W. F. , Rakhorst, H. , Ring, D. , & Chen, N. C. (2018). The prevalence of triangular fibrocartilage complex signal abnormalities on magnetic resonance imaging relative to clinical suspicion of pathology. The Journal of Hand Surgery, 43(9), 819–826 e811. - PubMed

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