- Question
- How should injuries to the triangular fibrocartilage complex be classified to guide diagnosis and treatment?
- Design
- Descriptive classification based on anatomy and clinical experience.
- Patients
- Patients with ulnar-sided wrist pain due to TFCC lesions.
- Intervention
- Classification into traumatic (Class 1) and degenerative (Class 2) lesions, subdivided by location and extent
- Comparison
- None
- Primary outcome
- Classification framework
- Key result
- Class 1 traumatic tears are subdivided by site (central, ulnar, distal and radial attachments), and Class 2 degenerative lesions are graded progressively from TFCC wear through perforation, chondromalacia and lunotriquetral ligament tear to ulnocarpal arthritis, reflecting ulnar impaction.
- Limitations
- Developed before modern arthroscopic understanding of the foveal attachment and DRUJ instability, so it does not fully capture deep foveal tears.
- Impact on practice
- Remains the standard classification for TFCC tears in exams and clinic, linking traumatic peripheral tears to repair and degenerative lesions to ulnar impaction management such as ulnar shortening or wafer procedures.