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https://www.readbyqxmd.com/read/28932701/mr-imaging-of-the-traumatic-triangular-fibrocartilaginous-complex-tear
#1
REVIEW
Alex W H Ng, James F Griffith, Cindy S Y Fung, Ryan K L Lee, Cina S L Tong, Clara W Y Wong, Wing Lim Tse, Pak Cheong Ho
Triangular fibrocartilage complex is a major stabilizer of the distal radioulnar joint (DRUJ). However, triangular fibrocartilage complex (TFCC) tear is difficult to be diagnosed on MRI for its intrinsic small and thin structure with complex anatomy. The purpose of this article is to review the anatomy of TFCC, state of art MRI imaging technique, normal appearance and features of tear on MRI according to the Palmar's classification. Atypical tear and limitations of MRI in diagnosis of TFCC tear are also discussed...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28865983/distal-radioulnar-joint-instability
#2
O Marès
Distal radioulnar joint (DRUJ) instability is a rare but disabling problem. Surgical treatment remains a challenge. The advent of arthroscopic techniques has helped to rebuild the triangular fibrocartilaginous complex (TFCC), especially its deep part. However, isolated TFCC damage is not responsible for instability. Its repair is sometimes not sufficient to restore DRUJ stability, or the chronicity of the injury prevents its direct repair. Open surgical procedures still have a role in these cases. They require a detailed knowledge of the various stabilizers of the DRUJ...
August 30, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28829171/advanced-imaging-techniques-of-the-wrist
#3
Andrew L Chang, Hon J Yu, Donald von Borstel, Taiki Nozaki, Saya Horiuchi, Yasuhiko Terada, Hiroshi Yoshioka
OBJECTIVE: This article covers the technical aspects and clinical applications of recent advancements in wrist MRI techniques, including T2 and T1rho mapping, compressed sensing, and isotropic 3D imaging using driven equilibrium sequences, variable-flip-angle refocusing pulse sequences, and parallel imaging. The clinical applications of these techniques include the quantitative analysis of cartilage and triangular fibrocartilaginous complex (TFCC) degeneration, faster scanning times, and improved resolution of complex wrist anatomy, allowing differentiation of degenerative from traumatic TFCC tears and improved morphologic evaluation of chondromalacia...
September 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28808768/high-resolution-mri-3t-mri-in-diagnosis-of-wrist-pain-is-diagnostic-arthroscopy-still-necessary
#4
Sabine Ochman, B Wieskötter, M Langer, V Vieth, M J Raschke, C Stehling
INTRODUCTION: 3T MRI has become increasingly available for better imaging of interosseous ligaments, TFCC, and avascular necrosis compared with 1.5T MRI. This study assesses the sensitivity and specificity of 3T MRI compared with arthroscopy as the gold standard. PATIENTS AND METHODS: Eighteen patients were examined with 3T MRI using coronal T1-TSE; PD-FS; and coronal, sagittal, and axial contrast-enhanced T1-FFE-FS sequences. Two musculoskeletal radiologists evaluated the images independently...
August 14, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28808764/high-resolution-3-t-mri-of-the-triangular-fibrocartilage-complex-in-the-wrist-injury-pattern-and-mr-features
#5
Huili Zhan, Huibo Zhang, Rongjie Bai, Zhanhua Qian, Yue Liu, Heng Zhang, Yuming Yin
OBJECTIVES: To investigate if using high-resolution 3-T MRI can identify additional injuries of the triangular fibrocartilage complex (TFCC) beyond the Palmer classification. MATERIALS AND METHODS: Eighty-six patients with surgically proven TFCC injury were included in this study. All patients underwent high-resolution 3-T MRI of the injured wrist. The MR imaging features of TFCC were analyzed according to the Palmer classification. RESULTS: According to the Palmer classification, 69 patients could be classified as having Palmer injuries (52 had traumatic tears and 17 had degenerative tears)...
August 15, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28644935/triquetrohamate-impaction-syndrome-an-unrecognized-cause-of-ulnar-sided-wrist-pain-its-presentation-further-defined
#6
Gary M Lourie, Colin Booth, Ross Nathan
BACKGROUND: The aim of this review was to further define the clinical condition triquetrohamate (TH) impaction syndrome (THIS), an entity underreported and missed often. Its presentation, physical findings, and treatment are presented. METHODS: Between 2009 and 2014, 18 patients were diagnosed with THIS. The age, sex, hand involved, activity responsible for symptoms, and defining characteristics were recorded. The physical findings, along with ancillary studies, were reviewed...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28643521/a-novel-all-inside-arthroscopic-technique-for-radial-sided-triangular-fibrocartilage-complex-tears-a-case-report-and-review-of-literature
#7
Michael T Edgerton, Robert C Kollmorgen
BACKGROUND: Triangular fibrocartilage complex (TFCC) injuries are a known cause of ulnar-sided wrist pain. Wrist arthroscopy is the gold standard for diagnosis of these lesions and is becoming a more frequent method of treatment. Isolated radial-sided tears are uncommon and treatment of these lesions is controversial. There are few reports on repair techniques. Here we report on a novel arthroscopic, all-inside technique for traumatic radial-sided TFCC tears that resulted in full range of motion, significant improvement in pain, and ultimately return to sport...
September 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28594695/wrist-arthroscopy-in-children-and-adolescent-with-chronic-wrist-pain-arthroscopic-findings-compared-with-mri
#8
Ashok L Ramavath, P N Unnikrishnan, Harvey L George, Paramasivam Sathyamoorthy, Colin E Bruce
BACKGROUND: Wrist arthroscopy is a dynamic diagnostic procedure and its indications are growing as a treatment modality in the adult population. The aim of the study was to retrospectively report our series of pediatric and adolescence with chronic wrist pain, with or without wrist instability who underwent wrist arthroscopy after failing at least 4 months of conservative management. Our secondary aim was to report the sensitivity and specificity of clinical examination and magnetic resonance imaging evaluation for various injury subgroups against the gold standard of the arthroscopic findings...
July 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28522258/high-resolution-3%C3%A2-t-mri-of-traumatic-and-degenerative-triangular-fibrocartilage-complex-tfcc-abnormalities-using-palmer-and-outerbridge-classifications
#9
T Nozaki, G Rafijah, L Yang, T Ueno, S Horiuchi, D Hitt, H Yoshioka
AIM: To investigate the usefulness of high-resolution 3 T magnetic resonance imaging (MRI) for the evaluation of traumatic and degenerative triangular fibrocartilage complex (TFCC) abnormalities among three groups: patients presenting with wrist pain who were (a) younger than age 50 years or (b) age 50 or older (PT<50 and PT≥50, respectively), and (c) asymptomatic controls who were younger than age 50 years (AC). MATERIALS AND METHODS: High-resolution 3 T MRI was evaluated retrospectively in 96 patients, including 47 PT<50, 38 PT≥50, and 11 AC...
October 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28511611/arthroscopic-assisted-resection-of-triangular-fibrocartilage-complex-lesions-a-19-year-follow-up
#10
Endre Soreide, Jan-Ragnar Haugstvedt, Torstein Husby
BACKGROUND: This study assesses long-term functional and subjective outcomes following arthroscopic assisted resection of lesions of the triangular fibrocartilage complex (TFCC). METHODS: Functional and subjective outcomes were assessed based on review of patient charts for patient demographic characteristics, comprehensive clinical evaluation, obtained radiographs, and patient-reported questionnaires. RESULTS: Fifteen patients, of whom 9 were female, and 10 dominant wrists, were included in this study...
May 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28465199/contribution-of-arthroscopy-to-the-treatment-of-intraarticular-fracture-of-the-distal-radius-retrospective-study-of-40-cases
#11
N Christiaens, G Nedellec, E Guerre, J Guillou, X Demondion, C Fontaine, C Chantelot
Our study aimed to compare the anatomical result after treatment of intraarticular distal radius fracture with locking volar plates with and without arthroscopy. This was a retrospective, single-center study of intraarticular fractures. A volar locked plate was used for fracture fixation in all patients. Twenty patients were operated on with fluoroscopy only ("plate" group) and 20 operated using arthroscopy assistance ("arthroscopy" group). All patients underwent a CT scan before surgery and at 3 months postoperative...
September 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28373941/arthroscopically-assisted-transosseous-foveal-repair-of-triangular-fibrocartilage-complex
#12
Wei-Jen Chen
The radioulnar ligament of the triangular fibrocartilage complex (TFCC), especially the deep fibers inserted at the ulnar fovea, is the key component for the distal radioulnar joint (DRUJ) stability. Traumatic injuries to the TFCC foveal insertion would cause DRUJ instability. Traditionally, arthroscopic techniques of the TFCC repair are suturing the ulnar-sided disruption peripherally to the dorsal or ulnar capsule instead of suturing the TFCC to the fovea and thus fail to restore the DRUJ stability if the TFCC is detached from the fovea...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28345546/high-resolution-3t-magnetic-resonance-imaging-of-the-triangular-fibrocartilage-complex-in-chinese-wrists-correlation-with-cross-sectional-anatomy
#13
Hui-Li Zhan, Wen-Ting Li, Rong-Jie Bai, Nai-Li Wang, Zhan-Hua Qian, Wei Ye, Yu-Ming Yin
BACKGROUND: The injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) could demonstrate the detailed complex anatomy of TFCC in Chinese. METHODS: Fourteen Chinese cadaveric wrists (from four men and three women; age range at death from 30 to 60 years; mean age at 46 years) and forty healthy Chinese wrists (from 20 healthy volunteers, male/female: 10/10; age range from 21 to 53 years with a mean age of 32 years) in Beijing Jishuitan Hospital from March 2014 to March 2016 were included in this study...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28339356/diagnostic-accuracy-of-musculoskeletal-ultrasound-and-conventional-radiography-in-the-assessment-of-the-wrist-triangular-fibrocartilage-complex-in-patients-with-definite-diagnosis-of-calcium-pyrophosphate-dihydrate-deposition-disease
#14
COMPARATIVE STUDY
Andrea Di Matteo, Emilio Filippucci, Fausto Salaffi, Marina Carotti, Davide Carboni, Eleonora Di Donato, Walter Grassi
OBJECTIVES: To compare the diagnostic accuracy of musculoskeletal ultrasound (MSUS) and x-ray in evaluating wrist triangular fibrocartilage complex (TFCC) in patients with calcium pyrophosphate dihydrate deposition disease (CPPD) and to investigate the agreement between the extent of the calcium pyrophosphate dihydrate (CPP) crystal deposits assessed by MSUS and the radiographic findings. METHODS: We enrolled 84 patients: 36 patients with "definite" CPPD and 48 controls...
July 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28259283/impact-of-distal-ulnar-fracture-malunion-on-distal-radioulnar-joint-instability-a-biomechanical-study-of-the-distal-interosseous-membrane-using-a-cadaver-model
#15
Satoshi Miyamura, Atsuo Shigi, Jirachart Kraisarin, Shohei Omokawa, Tsuyoshi Murase, Hideki Yoshikawa, Hisao Moritomo
PURPOSE: Certain distal ulna fractures may contribute to distal radioulnar joint (DRUJ) instability. We hypothesized that residual distal ulna translation could affect DRUJ stability by slackening the distal interosseous membrane (DIOM). We aimed to test this hypothesis in a cadaver model. METHODS: We created an ulnar translated distal ulna fracture model in 6 cadavers. Dorsal and palmar displacements of the ulna relative to the radius were measured and DRUJ instability was staged under the following conditions: (1) 0-, 2-, and 4-mm ulnar translation of the distal ulna with an intact triangular fibrocartilage complex (TFCC) and DIOM; (2) 0-, 2-, and 4-mm translations with TFCC divided and an intact DIOM; and (3) a 0-mm translation with TFCC and DIOM divided...
March 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28246600/can-the-diagnostics-of-triangular-fibrocartilage-complex-lesions-be-improved-by-mri-based-soft-tissue-reconstruction-an-imaging-based-workup-and-case-presentation
#16
Niels Hammer, Ulrich Hirschfeld, Hendrik Strunz, Michael Werner, Thomas Wolfskämpf, Sabine Löffler
Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT), 3 T magnetic resonance imaging (MRI), and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28211292/clinical-and-functional-outcome-of-open-primary-repair-of-triangular-fibrocartilage-complex-tears-associated-with-distal-radius-fractures
#17
Faisal Johandi, Sreedharan Sechachalam
PURPOSE: We evaluate the clinical and functional outcome of open primary repair of acute TFCC tears in distal radius fracture, when there is gross intraoperative distal radioulnar joint (DRUJ) instability after fixation of the distal radius, in the absence of an ulnar styloid fracture or when the ulnar fracture fragment is too small to be fixed. METHODS: A retrospective review of our institution's distal radius fracture database over a 4-year period (January 2010 to December 2013)...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28185125/ulnar-sided-wrist-pain-in-the-athlete-tfcc-druj-ecu
#18
REVIEW
Eric Quan Pang, Jeffrey Yao
PURPOSE OF REVIEW: The goal of this manuscript is to review key historic and recent literature regarding extensor carpi ulnaris (ECU), triangular fibrocartilage complex (TFCC) and distal radioulnar joint (DRUJ) injuries, particularly in athletes. RECENT FINDINGS: Many recent studies examining the ECU focus on clinical and radiographic diagnosis. Several physical exam findings are described in addition to the use of MRI and US. Imaging studies must be clinically correlated due to high incidence of findings in asymptomatic patients...
March 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28119800/ulna-rotation-osteotomy-in-complete-dislocation-of-the-distal-radioulnar-joint
#19
Markus Gabl, Rohit Arora, Eva Maria Gassner, Gernot Schmidle
Background Complete dislocation of the distal radioulnar joint (DRUJ) is a rare injury. Dislocation can present as uni- or multidirectional, acute or chronic, reducible or irreducible. It can occur due to isolated loss of ligamentous restraints or more frequent in Galeazzi - or Essex-Lopresti-type fractures. Case Description A 28-year-old man sustained a distal radius fracture and presented after conservative treatment with blocked supination. Examination revealed a malunion of the distal radius in combination with an irreducible dorsal dislocation of the DRUJ...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28119793/preventable-repeat-wrist-arthroscopies-analysis-of-the-indications-for-133-cases
#20
Steffen Löw, Christian K Spies, Frank Unglaub, Jörg van Schoonhoven, Karl-Josef Prommersberger, Marion Mühldorfer-Fodor
Background Frequently, patients undergo repeated wrist arthroscopies for single wrist problems. Purpose The purposes of this study were to assess the indications for repeat wrist arthroscopies and to identify potentially preventable procedures. Methods For this retrospective, two-center study, the electronic patient records were examined for patients, who underwent repeat wrist arthroscopy in a 5-year period. The cases were sorted by the underlying pathologies and the causes that necessitated repeat arthroscopies...
February 2017: Journal of Wrist Surgery
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