The triangular fibrocartilage complex of the wrist--anatomy and function.

The anatomy and function of the triangular fibrocartilage complex (TFCC) of the wrist was studied through anatomic dissections and biomechanical testing of 61 specimens. The TFCC was found to be a homogenous structure composed of, but not dissectable into, the articular disc, the dorsal and volar radioulnar ligaments, the meniscus homologue, the ulnar collateral ligament, and the sheath of the extensor carpi ulnaris. The TFCC was found to be perforated in 53% of specimens dissected, and all of the wrists with a demonstrable perforation showed evidence of damage or erosion of the cartilage of the lunate and/or distal ulna. Biomechanical studies suggest that the TFCC functions both as a cushion for the ulnar carpus and as a major stabilizer of the distal radioulnar joint. Perforations of the TFCC can result in the ulna-lunate abutment and cartilage erosion. Since excision of the TFCC may lead to ulnolunate abutment, chronic wrist pain, and/or instability of the distal radioulnar joint, it is not recommended.