MSK - Joint Injuries

Palmer Classification of TFCC Tears

Type 1: Traumatic
Class	Schematic	Description
1A		Central perforation or tear Avascular Debridement
1B		Ulnar avulsion with or without distal ulnar fracture, may involve the proximal and/or distal laminae (foveal and styloid attachments) Vascularized Surgical reattachment
1C		Distal avulsion (i.e. tear of the ulnolunate and/or ulnotriquetral ligaments) Vascularized Acute: ligament repair; Chronic: ulnar shortening
1D		Radial avulsion with or without sigmoid notch fracture Avascular Debridement
Type 2: Degenerative
Class	Schematic	Description
2A		TFC wear Avascular Debridement
2B		TFC wear with lunate and/or ulnar chondromalacia Avascular Debridement, ulnar shortening
2C		TFC perforation with lunate and/or ulnar chondromalacia Avascular Debridement, ulnar shortening
2D		TFC perforation, with lunate and/or ulnar chondromalacia, and lunotriquetral ligament perforation TFC: avascular; Ligament: vascularized Debridement, lunotriquetral partial arthrodesis
2E		TFC perforation, with lunate and/or ulnar chondromalacia, lunotriquetral ligament perforation, and ulnocarpal arthritis TFC: avascular; Ligament: vascularized Debridement, lunotriquetral partial arthrodesis

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SLAP Lesion Types

Type	Schematic	Description & Associations
I		Fraying More significant in young people with repetitive overhead motion; may be an incidental finding
II		Tear of biceps labral complex Most common SLAP, associated with SLAP IV
III		Bucket-handle tear Associated with fall on outstretched arm
IV		Bucket-handle tear with biceps extension Associated with SLAP II, fall on an outstretched arm
V		Bankart lesion with superior extension
VI		Anterior or posterior flap tear Probably represents a bucket-handle tear (SLAP III, IV) with tear of the handle
VII		Tear extends into middle glenohumeral ligament Acute trauma with anterior dislocation
VIII		Superior labral tear with posterior extension, similar but more extensive than SLAP IIB Associated with acute posterior dislocation
IX		Global (circumferential) labral abnormality Probably secondary to trauma
X		Rotator interval (SGHL) extension Articular-sided abnormalities

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