Atraumatic Bucket Handle Abnormality of the Triangular Fibrocartilage Complex in an Adolescent

Abstract

Background Congenital abnormalities of the triangular fibrocartilage complex (TFCC) are rare and could be mistaken for a traumatic lesion. It is important to recognize these anatomical variations and to realize they do not always require treatment. Case Description An incidental finding of an atraumatic bucket handle abnormality of the TFCC in a 15-year-old male, who was treated arthroscopically for dorsal wrist pain. This structure was resected, thus obtaining a normal looking peripheral TFCC. Literature Review Literature regarding congenital abnormalities of the TFCC is limited to a meniscoid articular disc or a congenital perforation. To our knowledge, an atraumatic bucket handle abnormality has not been described yet. Clinical Relevance This congenital abnormality of the TFCC could be mistaken for a traumatic lesion on MRI, or during wrist arthroscopy; therefore, it is important to realize that this entity may occur and does not require treatment.

A “Congenitally Adapted” TFCC Tear in Radial Longitudinal Deficiency: Case Report and Review of Literature

“…Further case reports highlight that arthroscopy finds pathology not detected on MRI with, for instance, a “bucket-handle” like structure in the TFCC where the MRI suggested a ganglion. 12 In line with our case, one case report describes a central perforation in a 17-year-old, where the author expressed doubts regarding the “degenerative” description, as per accepted classification of traumatic or degenerative TFCC tears, 7 and felt it unlikely to be degenerative in nature, given the patient's age and the normal articular surfaces of the ulnar head and carpus. 13…”

Arthroscopic Treatment of Bucket-Handle Triangular Fibrocartilage Complex Injury

“…1 Arthrography, arthroresonance, and arthroscopy may also be useful tools for diagnosis and potential treatment. 3 Triangular fibrocartilage complex alterations may be congenital or acquired. 3 It is important to recognize these variations to guide treatment.…”

“…3 Triangular fibrocartilage complex alterations may be congenital or acquired. 3 It is important to recognize these variations to guide treatment. Meniscoid articular disc and congenital perforations are highlighted among the anatomical variations of TFCC described in the literature, and the latter is the most common form.…”

“…1 Arthrography, arthroresonance, and arthroscopy may also be useful tools for diagnosis and potential treatment. 3 …”