The Dissect And Immunofluorescence Study Of The Innervation Of TFCC

Objective:As a ligamentous and cartilaginous complex, TFCC plays an important role on sustaining the stability of distal radioulnar joint (DRUJ),injuries to the triangular fibrocartilage complex are a common cause of ulnar-sided wrist pain and affect the function of the ulnocarpal joint.By the dissection of 10 adult upper-extremity specimens and immunofluorescence technique, the study examined the nervous origin and the distribution of the TFCC of the wrist, and provided the etiopathogenisis basis of ulnar-sided wrist pain, furthermore, provided a proof for clinical treatment of ulnar-sided wrist pain.Methods:Two fresh adult upper-extremity specimens and ten adult upper-extremity specimens fixed by 10% formaldehyde were separately studied by microdissection, and we observed the nervous origin and the contribution of the TFCC at 10×magnification. The quantitative study observed the innervation of TFCC via immunofluorescence technique with rat monoclonal antihuman PGP 9.5 antibody and Cy3-marked goat antirat IgG.To study the general structure of the TFCC, meanwhile, several frozen sections were stained with hematoxylin and eosin.Results:The microdissection study showed that the dorsal branch of the ulnar nerve and the medial antebrachial cutaneous nerve both had branch to the ulnar side of the wrist.The medial antebrachial cutaneous nerve had one branch to the surface of TFCC in five specimens,and it had two branchs to TFCC in another three specimens. In ten specimens,articular branches to the TFCC arose from the dorsal branch of the ulnar nerve, one branch in one specimen, two branches in three specimens, three branches in three specimens, and four branches in three specimens. TFCC could be simultaneously innervated by the dorsal branch of the ulnar nerve and the medial antebrachial cutaneous nerve. Immunofluorescence showed that IP of TFCC was chiefly innervated, and the radial aspects were not innervated.Conclusion:Articular branches to the TFCC can arise from the medial antebrachial cutaneous nerve and the dorsal branch of the ulnar nerve,not single innervation. And they are predominantly located on the ulnar side of the TFCC, especially in the IP.Refractoriness ulnar-sided wrist pain can be performed a operation of denervation.