The Influence of Early Gymnastic Exposure on the Triangular Fibrocartilage Complex in the Adolescent Wrist.

PURPOSE: This study aimed to evaluate triangular fibrocartilage complex (TFCC) appearance on magnetic resonance imaging (MRI) and the correlation between central triangular fibrocartilage (TFC) thickness and ulnar variance (UV) in adolescent asymptomatic gymnasts.

METHODS

This retrospective analysis of a prospective cohort selected 12-18 years old asymptomatic gymnasts and healthy controls from the Physeal MRI study, which is a single-center study on physeal injury that included gymnasts with wrist pain, asymptomatic gymnasts and healthy nongymnasts from June 2015 until November 2017. A standardized scoring form was used for assessment of TFCC morphology on MRI. Bone age and UV were determined on radiographs. TFCC morphology was assessed on 3T MRI and categorized. Statistical differences between groups were calculated using a chi-square test or Fisher exact test. Spearman's correlation coefficient was calculated between central TFC thickness and calendar/bone age, UV, height, and weight. Correlations were interpreted as poor (≤0.20), fair (0.21-0.40), moderate (0.41-0.60), substantial (0.61-0.80), and excellent (0.81-1.00). Multiple linear regression was performed to determine predictors of central TFC thickness.

RESULTS

Forty-one adolescents (23 nongymnasts, 18 gymnasts, median age 14 years, 21 female) were included. No differences were found in TFCC appearance. Correlations between central TFC thickness and UV were substantial in both groups. Multiple linear regression analysis showed that UV and bone age together were significant predictors for central TFC thickness in nongymnasts (P < .001). However central TFC thickness could not be predicted by UV and bone age in gymnasts.

CONCLUSIONS

Early gymnastic exposure does not influence TFCC appearance on MRI. However, a misbalance between central TFC thickness and UV appears to exist for adolescent gymnasts and this should be taken into consideration when assessing gymnastic wrist injury.

TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic III.