Table 1.

Classification of ulnar triangular fibrocartilage complex (TFCC) tears according to Atzei et al (63).

Type 1 Isolated tears of the distal triangular fibrocartilage complex (TFCC) without distal radio-ulnar joint (DRUJ) instability and are amenable to arthroscopic suture.

Type 2 Rupture of both the distal triangular fibrocartilage complex (TFCC) and proximal attachments of the triangular fibrocartilage complex (TFCC) to the fovea.

Type 3 Isolated ruptures of the proximal attachment of the triangular fibrocartilage complex (TFCC) to the fovea; they are not visible at radio-carpal arthroscopy.

Type 4 Irreparable tears due to the size of the defect or to poor tissue quality and, if required, treatment is through distal radio-ulnar ligament reconstruction with tendon graft.

Type 5 They are associated with distal radio-ulnar joint (DRUJ) arthritis and can only be treated with salvage procedures. This subdivision of type IB triangular fibrocartilage complex (TFCC) tear provides more insights in the pathomechanics and treatment strategies.

Both class 2 and class 3 tears are diagnosed with a positive hook test and are typically associated with distal radio-ulnar joint instability. If required, treatment is through reattachment of the distal radio-ulnar ligament insertions to the fovea.