Triangular Fibrocartilage Complex (TFCC) Tear Treatment
What is TFCC?
The TFCC is made up by a group of ligaments that connect the wrist (carpal) bones and forearm (radius and ulna) bones together. It is one of the main stabilising structures of the wrist. A disc of cartilage lies in the centre of this ligament complex, which is particularly prone to tears. The TFCC can become painful as a result of a traumatic tear or degenerative wear and tear.
TFCC tear causes
TFCC tears can be caused by traumatic injury or through degenerative wear and tear. Traumatic tears of the TFCC may be the result of falling on an outstretched hand, forceful twisting of the wrist, or from a sudden blow to the wrist. The TFCC can also tear during certain sporting activities including cricket, tennis and golf. Repetitive overuse of the wrist over time can cause degenerative wear and tear. Manual activities including gardening, handling heavy luggage or lifting heavy weights can increase the wear and tear on the TFCC.
TFCC tear 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 from side to side and is often accompanied by swelling. Sometimes a TFCC tear can cause hand deformities. If the TFCC is damaged, you may notice a painful clicking sensation or feel that your grip strength is reduced.
TFCC tear diagnosis
Your consultant will take a thorough medical history and do a physical examination. An MRI may be used to diagnose the injured cartilage.
In some cases the MR images do not show the injured cartilage. In this case, arthroscopy may be used to directly inspect the TFCC. This is a type of keyhole surgery using a small telescope to look inside the wrist.
TFCC tear treatment
Non-surgical treatment
Rest, ice and pain relief in the form of anti-inflammatory medications are effective in managing symptoms in the early stages. These can be used alongside a splint to minimise movement in the wrist, allowing the pain and inflammation to settle. In some cases, a steroid injection may be necessary to reduce the inflammation and relieve symptoms. Hand therapy to stabilise the wrist and support the injured TFCC can often resolve symptoms.
Surgical treatment
In severe cases an operation may be considered to remove damaged tissue or to reattach a torn ligament. This may be performed using wrist arthroscopy surgery or with open surgery.
TFCC Tear Treatment options
The One Orthopaedics team specialists
Anthony Hearnden
Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Shoulder, Elbow, Hand and Wrist
