CONTEMPORARY IMAGING, ARTHROSCOPIC REPAIR, AND FUNCTIONAL REHABILITATION IN TRAUMATIC TRIANGULAR FIBROCARTILAGE COMPLEX TEARS: A NARRATIVE REVIEW

Abstract

Traumatic triangular fibrocartilage complex (TFCC) tears are an important cause of ulnar-sided wrist pain, reduced grip strength, restricted forearm rotation, and distal radioulnar joint (DRUJ) instability. Their diagnosis and management remain challenging because morphological abnormalities do not always correlate with symptoms or functional impairment. This narrative review summarizes contemporary concepts in the diagnosis, treatment, and rehabilitation of traumatic TFCC tears, with particular emphasis on modern imaging and arthroscopic technologies. English-language publications were identified through PubMed without restrictions on publication year. The reviewed evidence indicates that diagnosis should integrate the mechanism of injury, physical examination, bilateral assessment of DRUJ stability, and imaging findings. Magnetic resonance imaging and magnetic resonance arthrography improve visualization of TFCC lesions, but incidental abnormalities and variable diagnostic performance limit their use as isolated decision-making tools. DRUJ stability appears to be a key factor in treatment selection. Structured non-operative management may provide satisfactory outcomes in patients with a stable DRUJ, whereas persistent symptoms, mechanically unstable tears, and foveal detachment may require surgical intervention. Contemporary arthroscopic options include all-inside repair, suture-anchor fixation, and transosseous techniques, although current evidence does not establish a single superior method. Postoperative rehabilitation protocols remain heterogeneous, and validated criteria for progression and return to work or sport are lacking. Future research should focus on standardized diagnostic pathways, comparative evaluation of repair techniques, objective functional monitoring, and patient-centered return-to-activity outcomes. Modern technologies should support, rather than replace, integrated clinical and functional assessment.