Triangular fibrocartilage complex injuries in the elite athlete. The ulnar collateral ligament can also be damaged by overuse and repetitive stress, such as the throwing motion. Background: The ulnar collateral ligament complex includes the ulnar proper collateral ligament and the ulnar accessory collateral ligament. Differential diagnosis of ulnar sided wrist pain includes: “synovitis, lunotriquetral ligament injuries, extensor carpi ulnaris subsheath injuries, ulnar extrinsic ligament injuries, and TFCC tears” (Park, Jagadish, & Yao., 2010, p. 3).In general, a wait and see approach with immobilisation is used for acute wrist injuries, however in the athletic population, early detection of a TFCC injury is necessary to determine what course of treatment is most appropriate.“The gold standard for diagnosing TFCC disorders remains.As you can see from above, the type of surgery performed depends heavily on the injury which is diagnosed. This includes immobilisation, NSAIDS or CSI and occupational therapy (Ko & Wiedrich., 2012). JBJS, 88(4), 884-894.Tay, S. C., Tomita, K., & Berger, R. A. Numbness and paresthesias are not typical findings.The physical examination begins with the uninvolved thumb, noting the individual’s normal range of motion and stability. The fracture presents with swelling or discoloration on the ulnar side of the first MCP joint and tenderness along the base of the proximal phalanx. Sachar, K. (2008). Immobilisation may allow for partial peripheral tears without DRUJ instability to heal. Effect of untreated triangular fibrocartilage complex (TFCC) tears on the clinical outcome of conservatively treated distal radius fractures. Standardized ultrasound technique, which includes dynamic imaging, should be a consideration when the ultrasound examination is performed for this diagnosis. Journal of Hand Surgery, 21(5), 581-586.Park, M. J., Jagadish, A., & Yao, J. Complete tears can fold back proximally when they are ruptured distally and become interposed between the adductor aponeurosis. In the acute injury setting, patients can often recall the instant of injury. Journal of Hand Surgery, 37(7), 1489-1500.Szabo, R. M. (2006). A study of downhill skiing found that thumb injuries accounted for 17% of skiing injuries, second only to knee injuries. Tears can occur if a valgus force is applied to an abducted first MCP joint. A plain radiograph is essential to rule out an avulsion fracture of the base of the ulnar side of the proximal phalanx. Orthopedics, 33(11).Prosser, R., Harvey, L., LaStayo, P., Hargreaves, I., Scougall, P., & Herbert, R. D. (2011). Each of these movements can be performed with varying levels of grip force. As clinicians you will need to rely on your clinical reasoning to understand the meaning of the findings from your physical exam.Blue (TFCC), green (lunotriquetral interval), pink (scapholunate interval), and orange (DRUJ).Prosser et al (2011) suggest the following.As you can see from the assessment and anatomy sections above, there are many causes of ulnar-sided wrist pain from structures other that the TFCC. Functional anatomy of the triangular fibrocartilage complex. Tears can occur if a valgus force is applied to an abducted first MCP joint. A UCL consists of three bands or divisions: the anterior (front), posterior (back) and transverse (across) bands. A lesion of the UCL is commonly called skier’s … Review of the literature on US examination of UCL tears shows an overall sensitivity of 76%, specificity of 81% accuracy, positive predictive value of 74% and a negative predictive value of 87%. The ulnar collateral ligament was seen between ulnar styloid process and the triquetrum. Provocative wrist tests and MRI are of limited diagnostic value for suspected wrist ligament injuries: a cross-sectional study.