Background: TFCC injury as one of the causes of ulnar wrist pain, there are still many uncertainties, and the clinical significance of TFC abnormalities has not been fully established. Few investigators have emphasized the importance of findings on plain radiographs in detecting a TFC tear, other than that of ulnar positive variance. The purpose of this retrospective study was to evaluate arthroscopic findings of TFC injuries and their association with radiological findings. Methods: Between July 2002 to May 2007, 94 wrists from 94 patients (mean age, 25.8 years) were retrospectively studied to clarify the pathology and morphology of TFC's and to identify the relationship between arthroscopic and radiological findings. We reviewed preoperative radiographs and measured ulnar variances using the method of perpendiculars, and examined the relationship between ulnar variance and TFC injury pattern. Results: The preoperative radiologicl findings showed 61.7% of patients with positive ulnar variance (mean, 0.24; range, 0.08-0.47) and 21.3% with negative ulnar variance (mean, 0.23; range, 0.07-0.42). Type IB TFC injury was the most common injury pattern (62.7%) and was associated with a higher proportion of intra-articular injuries such as scapho-lunate and/or lunotriquetrum ligament tears. Conclusion: Our findings show that ulnar variance is likely to be an important risk factor for TFCC perforation. Relative excess ulnar length is associated with increased incidence of TFC perforation resulting from increased loading force transmitted to the forearm unit through the distal ulna via the triangular fibrocartilage complex.
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