The triangular fibrocartilage complex (TFCC) is formed by collagenous fibers (ligaments) implanted in a fibrocartilage matrix that extends to the extremity of the radius and ulna. This keeps the forearm bones stable when they rotate or when the hand is grasping. Triangular ligament injuries are a frequent cause of ulnar pain and can be caused by either traumatic or degenerative processes.
This condition, also known as Ulnocarpal Abutment Syndrome, is a degenerative wrist condition where the ulnar head impacts the ulnar-sided carpus compressing the triangular ligament and damaging the TFCC. It causes ulnar-sided wrist pain. It is attributed to positive ulnar variance which can be congenital or have resulted from a distal radius fracture with malunion, a consequence of trauma to the radius junction or injury to the elbow.
The pain is insidious and progressive increasing with sports activity and with pronation and ulnar deviation.
This condition is associated with wrist pain on the little finger side, caused by a short ulna and a long styloid. When the styloid is too long it presses against the bones of the wrist, particularly the triquetrum bone and can lead to synovitis.
Cartilage is the tissue that covers the joint surfaces, reducing friction and allowing for proper joint movement. Articular cartilage damage in the wrist produces pain, blockages and decreased mobility, leading to wear and arthritis.
Most chondral wrist injuries are secondary to distal radius joint fractures.
Wrist arthroscopy is used both for diagnosis and removing free bodies. Several treatment options are possible:
This injury usually involves the tendon and sheath of the extensor carpi ulnaris and is often caused by repetitive movements that combine lifting, impact, twisting or throwing. It is usually a slow progressive injury common with tennis players, golf players and weight lifters.
This injury is caused by compression of the median nerve that passes through the carpal tunnel and is characterized by numbness and tingling in the hand and pain that radiates up the arm especially at night.
It is the most frequent nervous compression of the upper extremity and most causes are unknown, although they can come from anatomical or physiological causes such as diabetic neuropathies, position and use of the wrist.
These are benign cystic tumors - small sacs of fluid that form over a joint or tendon. They are usually asymptomatic although sometimes painful. Dorsal ganglions are the most frequent type of wrist ganglia followed by Volar ganglions.
In 50% of cases they are reabsorbed without treatment.
De Quervain’s tenosynovitis produces inflammation of the tendon and the sheath that covers it on the thumb side of the wrist. It can be due to chronic overuse of your wrist, repetitive hand or wrist movements and causes pain when you turn your wrist, grasp something or make a fist. It is common with golfers and tennis players and women aged thirty to fifty years.
Carpal Boss is an overgrowth of bone where your index finger meets the carpal bones, causing a firm bulge on the dorsal part of the hand. The cause is not clear but could be related to overuse and repetitive motions as it tends to occur on the dominant hand. It is usually asymptomatic.
These fractures are usually due to low energy trauma when you fall on your outstretched hands. They are very common, with fractures to the distal end of the radius being the most frequent.
The fractures can be classified as:
Due to the complexity and possibility of associated injuries to the scapholunate ligament, triangular fibrocartilage and median nerve, treatment is determined on a case by case basis.
This is one of the most frequent fractures of the carpus involving one of the small carpal bones on the thumb-side of the wrist and has a high incidence of associated injuries. It is mainly caused by falling on an outstretched hand.
Although quite rare, these are the second most frequent carpal fractures and are often associated with other carpal injuries. Most are recognized when they produce Kienböck's disease (avascular necrosis). They are also typically caused by falling on an outstretched hand.
This condition occurs when the flexor tendon is hindered from sliding normally within its sheath usually in flexion. It produces a snapping sensation, making it difficult to bend the affected finger or thumb. It is more frequent with people who perform repetitive gripping motion. The stiffness is also more typical in the morning, with the thumb or finger becoming stuck in flexion.