TFCC Injury Hand Orthobullets. Fall from standing onto an extended and pronated wrist is a risk factor for injuries to the soft tissues of the wrist. The structures at risk include the triangular fibrocartilaginous complex TFCC, the lunotriquetral ligament, ulnolunate ligament, hook of hamate, ulnar styloid, and the extensor carpi ulnaris ECU tendon sheath. Pain with resisted ulnar deviation and ulnar catching are all concerning for injury to the TFCC. MRI is useful for diagnosing TFCC tears Illustration A shows another example. Papapetropoulos et al in their review article discuss the evaluation and arthroscopic treatment of TFCC injuries. Specifically they discuss that most tears in athletes are acute and amenable to repair by repair of the dorsal tear to the ECU tendon sheath. Cohen in his review of injuries in athletes discusses scapholunate ligament, lunotriquetral ligament, and midcarpal injuries. Of note he divides scapholunate and lunotriquetral ligament injuries into dissociative lesions abnormal motion within proximal carpal bones vs. Rettig in his review of sports injuries of the extremities discusses the Palmer classification of TFCC tears. Specifically he notes that central tears are more associated with repetitive activities in patients with positive ulnar variance. Incorrect Answers. Answer 1 The patient is not tender in the region of the ECU tendon sheath. Leading Wound Care Products provided by Smith Nephew Advanced Wound Management. The clinical description and video of the patients physical exam are consistent with an acute scapholunate ligament tear. Secure Keygen. The video shown in the question stem. Introduction Mechanism of TFCC injury. Type 1 traumatic injury. Dr. Edward Moon, MD, practices at Palo Alto Medical Foundation in San Carlos Palo Alto, California. Learn more about Dr. Richard Wolfson Essential University Physics Volume 2 Pdf'>Richard Wolfson Essential University Physics Volume 2 Pdf. Moons practice status and areas of focus. Tfcc Ligament Tear Repair' title='Tfcc Ligament Tear Repair' />Answer 3 The carpal tunnel view radiograph shows no hook of hamate fracture. Directsoft 6. Answer 4 and 5 Wrist radiographs shows no scapholunate widening or perilunate dislocation. Physical exam in this case is more consistent with a TFCC injury. Portals/1/PackFlashItemImages/WebReady/WristArthroscopy2.jpg' alt='Tfcc Ligament Tear Repair' title='Tfcc Ligament Tear Repair' />MRI impression 1. Central TFCC tear and Probable tearsmall perforation at the lunotriquetral liagament. No bony changes involving the proximal lunate or distal ulna.