Do small everyday moves, such as grabbing something or using your hand to get up from the chair become painful? If so, then it is very likely for a lesion to be present in the triangular cartilage, or, more properly, in the triangular fibrocartilage complex (TFCC), a complex anatomical region in the radiocarpal joint.
Its purpose is to absorb shocks, stabilise the wrist, and also transmit the movement from the wrist to the ulna. It is located between the lower end of the ulna and the bones of the wrist. It consists of the triangular fibrocartilage discus (TFC), the peripheral cartilage which is analogous to the meniscus of the knee, the radioulnar ligaments (RUL’s), and the sheath of the extensor carpi ulnaris.

The injury can be related to a fall upon the outstretched hand (extension-pronation position), or it may be the result of overuse of the wrist, so we are talking about a degenerated cartilage, as part of the normal aging process.
High-risk groups include high-performance athletes - such as boxers, tennis and athletes of artistic and rhythmic gymnastics - or workers using electric drills or screwdrivers. In addition, the triangular cartilage injury is associated with 80% of the distal radius fractures, or may be attributed to an anatomical variation of the ulna (the ulna may be longer than the radius).

Symptoms of disruption in this fibrous complex are pain in the volar ulnar rim (namely, the side where the small finger is located), which is aggravated at sites that reproduce the injury mechanism, as well as swelling. So, opening a bottle or using a wrench can cause pain. There may also be a sensation of a crackling sound when moving the wrist or rotating the forearm.
On the other hand, as it is a degenerative lesion, patients who have not been diagnosed with it (and usually have suffered a small injury) may reach the point where they can not pour water out of a jug without feeling pain in the wrist. Epidemiological studies indicate that injuries to the triangular cartilage (either due to a disruption, or degenerative ones) are present in at least 50% of the population aged 60 and over.

Diagnosis requires a complete clinical examination, even of the elbow, and the obtaining of a detailed history. Simple X-rays shall not confirm the presence of an injury. The most reliable examination is arthography, while an MRI is considered an optional test, which shall offer a clearer picture.
Disruptions - mainly degenerative ones - are initially treated conservatively, with analgesics, immobilization of the radiocarpal joint in a splint for about 6 weeks, ice therapy, rest and physiotherapy. However, the poor blood supply of the triangular cartilage (only 15-20% is well vascularized) explains the difficulty regarding its healing. Thus, in disruptions which continue to cause pain or are too severe, surgical treatment is an effective option.
Arthroscopy technique (the arthroscope and thin surgical instruments are inserted through very small incisions) enables the surgeon to recognize the type of disruption and, accordingly, decide whether to perform a surgical lavage or to reset the detached cartilage to its anatomical position.

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