Crowe Christopher S, Kakar Sanj
Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Bone Joint J. 2023 Jan;105-B(1):5-10. doi: 10.1302/0301-620X.105B1.BJJ-2022-0908.R1.
Injury to the triangular fibrocartilage complex (TFCC) may result in ulnar wrist pain with or without instability. One component of the TFCC, the radioulnar ligaments, serve as the primary soft-tissue stabilizer of the distal radioulnar joint (DRUJ). Tears or avulsions of its proximal, foveal attachment are thought to be associated with instability of the DRUJ, most noticed during loaded pronosupination. In the absence of detectable instability, injury of the foveal insertion of the radioulnar ligaments may be overlooked. While advanced imaging techniques such as MRI and radiocarpal arthroscopy are well-suited for diagnosing central and distal TFCC tears, partial and complete foveal tears without instability may be missed without a high degree of suspicion. While technically challenging, DRUJ arthroscopy provides the most accurate method of detecting foveal abnormalities. In this annotation the spectrum of foveal injuries is discussed and a modified classification scheme is proposed.Cite this article: 2023;105-B(1):5-10.
三角纤维软骨复合体（TFCC）损伤可能导致尺侧腕部疼痛，伴或不伴有不稳定。TFCC的一个组成部分，即桡尺韧带，是桡尺远侧关节（DRUJ）的主要软组织稳定结构。其近端、凹部附着处的撕裂或撕脱被认为与DRUJ的不稳定有关，在负重旋前旋后时最为明显。在没有可检测到的不稳定的情况下，桡尺韧带凹部附着处的损伤可能会被忽视。虽然MRI和桡腕关节镜等先进成像技术非常适合诊断TFCC中央和远端撕裂，但如果没有高度怀疑，可能会漏诊无不稳定的部分和完全凹部撕裂。虽然技术上具有挑战性，但DRUJ关节镜检查是检测凹部异常最准确的方法。在本注释中，讨论了凹部损伤的范围，并提出了一种改良的分类方案。引用本文：2023；105-B(1):5-10。
