Triangular Fibrocartilage Complex (TFCC) Tear

TFCC is a cartilage located in the wrist at the side of a small finger that acts as cushion and support for carpal bones of the hand. It is also considered as the major ligamentous stabilizer of distal radioulnar joints and the ulnar carpus. It also keeps the forearm bones stable with movements of grasp and rotation. An injury or tear to the TFCC can cause chronic wrist pain that is often misdiagnosed by the practitioners due to its close relationship with other structures in the area.

TYPES OF TFCC tears

There are two types of TFCC tears.

1. Type 1 tears are called traumatic tears. Falling on an outstretched hand and excessive arm rotation are the most common causes.
2. Type 2 TFCC tears are degenerative or chronic. They can occur over time and with age. The degenerative process wears the cartilage down over time. Degenerative tears mostly appear after the age of 50. Some inflammatory disorders, such as rheumatoid arthritis or gout, may also contribute to Type 2 TFCC tears.

SYMPTOMS

Symptoms include:

• Pain, at the base of small finger side of the wrist
• Pain worsens as the wrist is bent from side to side
• Swelling in the wrist
• Painful clicking in the wrist
• Loss of grip strength

DIAGNOSIS

Careful examination of the wrist is required to rule out TFCC. An X-ray may be required depending on the severity of pain and inflammation to check for fractures and other abnormalities. The most reliable imaging test is an MRI, which allows doctors to inspect the tissue and cartilage to see the extent of the injury.

TREATMENT

Non-surgical treatment options include:

• Splint or cast

Surgical treatment options include:

Surgery is generally needed for those tears that don’t heal or respond to the conservative treatment. This can be performed arthroscopically through limited incisions. Recovery is several weeks in a cast or splint. Therefore, post surgical rehab usually requires physiotherapy to get the wrist back to full function.