Morphology of the Ulnar Insertion of the Triangular Fibrocartilage Complex and Related Osseous Landmarks. 2021

Masato Okuda, and Kotaro Sato, and Yoshikuni Mimata, and Kenya Murakami, and Gaku Takahashi, and Minoru Doita
Department of Orthopaedic Surgery, Iwate Medical University, Iwate, Japan. Electronic address: mstoct02@gmail.com.

In triangular fibrocartilage complex (TFCC) injuries, a foveal tear of the radioulnar ligament often requires surgery. Previous studies have suggested that surgeons should attach the TFCC to the center of the fovea. The TFCC and its insertion points are small structures, and few studies have reported details of the foveal insertion. This study aimed to clarify the morphology of the ulnar insertion of the TFCC and related osseous landmarks with 3-dimensional imaging. This study used 26 formalin-fixed cadavers. At the ulna, the TFCC was inserted from the fovea to the middle part of the ulnar styloid. After gross observation of the TFCC, the ulnar insertion was outlined using a 1.0-mm drill. We then created 3-dimensional images of the ulna using computed tomography and marked (with software) an outline of the foveal insertion of the TFCC. We measured the area and the long and short diameters of the TFCC insertion. The area of the TFCC insertion was 34 mm2 and positively correlated with the height of the ulnar styloid and the area of the ulnar head. The TFCC's highest point was 58% of the ulnar styloid height. The center of the TFCC insertion was 1.3 mm ulnar and 0.6 mm dorsal from the lowest point of the ulnar surface. The center of the TFCC insertion was slightly ulnar of the lowest point of the ulnar surface. This study revealed the center, the area, and the osseous relation of the ulnar insertion of the TFCC. When surgeons repair a TFCC foveal tear, they can find the anatomical center of the ulnar insertion efficiently and easily based on its osseous relationship.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001182 Arthroscopy Endoscopic examination, therapy and surgery of the joint. Arthroscopic Surgical Procedures,Surgical Procedures, Arthroscopic,Arthroscopic Surgery,Surgery, Arthroscopic,Arthroscopic Surgeries,Arthroscopic Surgical Procedure,Arthroscopies,Procedure, Arthroscopic Surgical,Procedures, Arthroscopic Surgical,Surgeries, Arthroscopic,Surgical Procedure, Arthroscopic
D012421 Rupture Forcible or traumatic tear or break of an organ or other soft part of the body. Ruptures
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography
D014457 Ulna The inner and longer bone of the FOREARM. Semilunar Notch,Trochlear Notch,Ulnar Coronoid Process,Ulnar Trochlear Groove,Coronoid Process, Ulnar,Semilunar Notchs,Trochlear Groove, Ulnar,Trochlear Notchs,Ulnar Coronoid Processes,Ulnar Trochlear Grooves,Ulnas
D014954 Wrist Injuries Injuries to the wrist or the wrist joint. Injuries, Wrist,Injury, Wrist,Wrist Injury
D017535 Ulnar Artery The larger of the two terminal branches of the brachial artery, beginning about one centimeter distal to the bend of the elbow. Like the RADIAL ARTERY, its branches may be divided into three groups corresponding to their locations in the forearm, wrist, and hand. Arteries, Ulnar,Artery, Ulnar,Ulnar Arteries
D051478 Triangular Fibrocartilage Fibrocartilage that makes up the triangular fibrocartilage complex which is found in the WRIST JOINT. Triangular Fibrocartilage Complex,Complex, Triangular Fibrocartilage,Fibrocartilage Complex, Triangular,Fibrocartilage, Triangular,Fibrocartilages, Triangular,Triangular Fibrocartilages

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