Review and update on the management of triangular fibrocartilage complex injuries in professional athletes

Table 1 Palmer’s classification

Type 1 acute traumatic injury	Type 2 degenerative injury
Isolated central TFCC articular disk perforation	TFCC wear
Peripheral ulnar-sided TFCC tear with or without ulnar styloid fracture	TFCC wear with lunate and/or ulnar chondromalacia
Distal TFCC disruption (disruption of the distal ulno-carpal ligaments)	TFCC perforation with lunate and/or ulnar chondromalacia
Radial TFCC disruption with or without sigmoid notch fracture	TFCC perforation with lunate and/or ulnar chondromalacia and with lunotriquetral ligament perforation
	TFCC perforation with lunate and/or ulnar chondromalacia, lunotriquetral ligament perforation and ulno-carpal arthritis

TFCC: Triangular fibrocartilage complex.

Table 2 Diagnosis of TFCC injuries

Clinical tests	Radiological tests
Areas of tenderness	X-ray (AP and lateral view)
Ulnar fovea sign	CT (rarely)
Piano key test	MRI
Ulnar grinding test	Wrist arthrogram
Compression test	Wrist arthroscopy (gold standard)
Ballottement test
ROM evaluation

AP: Antero-posterior; ROM: Range of motion; CT: computed tomography; MRI: Magnetic resonance imaging.