Triangular Fibro Cartilaginous Complex (TFCC) Tears
The TFCC is an important stabilising structure which is situated on the little finger side of the wrist. It’s composed of a group of ligaments and cartilage that connects the ulna to the radius and wrist ‘carpal’ bones.
Why does it occur?
TFCC tears may be caused through trauma or degenerative wear and tear. Trauma in a healthy TFCC can occur through direct blow to the wrist or indirectly, such as a fall onto an outstretched hand or forceful twisting of the wrist. The latter is particularly relevant in activities such as racquet sports or golfing. Degenerative tears are more common in patients over the age of 50 years or those who engage in manual activities with repetitive wrist use such as gardening or lifting heavy weights.
What are the symptoms?
Damage to the TFCC can be very painful, particularly on the little finger side of the wrist. This is exacerbated as the wrist moves side to side and accompanied by swelling. You may notice a painful clicking sensation or feel your grip strength is reduced.
How is it diagnosed?
Your clinician will take a thorough history and examination. Further imaging may be utilised to rule out an alternative diagnosis, most commonly in the form of MRI scan. This may be combined with an injection of contrast dye into the wrist joint – an MRI arthrogram, in order to view the injured cartilage. In some cases, an arthroscopy is used to directly inspect the TFCC.
How is it treated?
Rest, ice and analgesics in the form of anti-inflammatory medications such as ibuprofen are effective in managing mild cases. This can be accompanied with a splint to minimise movement in the wrist whilst the pain settles. In some cases, a steroid injection is utilized to reduce the inflammation and relieve symptoms.
In severe cases operative management is considered to remove the tissue. This may be done via ‘key-hole’ arthroscopic surgery or in more extensive tears, via an open approach.
The One Team Specialists
Consultant Orthopaedic Knee Hip Specialist BM BCh, BA Hons, FRCS(Tr & Orth)
Knee Specialist FRCS(Orth)
Consultant Orthopaedic Surgeon BSc (Hons), FRCS (Tr & Orth)