TFCC: A DRUJ perspective

Abstract

The triangular fibrocartilage complex represents the distal boundary of the distal radioulnar joint. Two fundamental pathologies of this complex are best managed by arthroscopic techniques performed from the distal radioulnar joint perspective. Chronic attrition of the undersurface of the fibrocartilage disc rubbing against the ulnar head leads to a degenerative pattern of horizontal and multiplanar tearing of the disc substance as well as synovitis in the sigmoid notch. Simple debridement of the tear and the synovitis can be combined with arthroscopic resection of the distal ulna for a complete management of this chronic pattern. Acute avulsion of the radioulnar ligament from the fovea can be diagnosed by clinical examination but confirmed by distal radioulnar joint arthroscopy. The torn and retracted edge of the radioulnar ligament can be arthroscopically reattached to the prepared base of the fovea.