Tringular Fibrocartlidge Complex

Triangular fibrocartilage complex injuries are also seen in golfers. The triangular fibrocartilage complex is a structure on the ulnar side (outside) of the wrist, which is important to wrist stability (Fig. 3). With the increased motion of the wrist that occurs in golfers, this structure is prone to tearing. Very often, nonoperative treatment, such as rest, reduction of play, and nonsteroidal anti-inflammatory drugs, is successful in relieving pain. If it is not, the inflamed tissue can be removed by arthroscopic surgery (surgery using small incisions). If the cartilage tear is large, repair of the cartilage through an open incision is sometimes necessary.

Golfers can break their hamate, or wrist bone, with a "fat" shot or in cold weather when the hand strikes the hard ground with the club, the force is transmitted to the bone (Fig. 4). The butt of the golf club rests against the hook of the hamate, a bone in the wrist. Diagnosis is usually made by physical examination and confirmed with x-rays. If found and treated early, this fracture will heal in a cast. However, many hamate injuries are diagnosed late. In these patients, removing the bone to relieve the pain is sometimes necessary. Patients should understand that this bone is closely related to important structures of the hand, including the ulnar artery and ulnar nerve, and both structures can be involved in the injury or affected by surgical intervention.

Although golf injury is rare, the wrist is one of the most commonly injured anatomic locations in the sport. Wrist injuries can occur not only in the average golfer but also in the high-level professional. They are usually the result of overuse due to excessive practice, or excessive play or poor mechanics that place the wrist at risk. Nonsurgical treatment is usually effective; however, in some patients, surgical treatment is necessary to return the patient to play.