WHAT IS A TFCC WRIST INJURY?
(Triangular Fibrocartilage Complex Injury)
Topic at a Glance
- The triangular fibrocartilage complex (TFCC) is a group of cartilage and ligaments on the pinky-finger side of the wrist that helps cushion the joint and stabilize the forearm.
- TFCC tears can result from falls onto an outstretched hand, direct wrist injuries, repetitive movements, or cartilage degeneration over time.
- Symptoms may include wrist pain, swelling, tenderness, clicking, reduced grip strength, and difficulty rotating the forearm or bearing weight through the wrist.
- Treatment depends on the severity of the injury and may include rest, anti-inflammatory medication, splinting, physical therapy, corticosteroid injections, or surgery for more severe tears.
The wrist is a complex structure made up of the forearm muscles, connective tissues, bones, and cartilage that enables the movement of the wrist, hand, and fingers. When any of these structures gets injured, it can cause pain and affect wrist function.
If you have had a recent wrist injury and would like an accurate diagnosis, schedule a consultation with our hand, wrist & elbow experts at OrthoNeuro. Our doctors offer accurate diagnoses and treatment plans that are tailored to you. Call or schedule an appointment online at one of our multiple locations in Columbus, Ohio.
A TFCC Wrist Injury Explained
A TFCC injury is an injury to the soft tissues in the wrist known as the triangular fibrocartilage complex (TFCC). These soft tissues help support and cushion the bones in the wrist (carpal bones) and stabilize the forearm.
The TFCC is a disc made of cartilage and ligaments on the ulnar side of the wrist (area near the pinky finger). The TFCC is part of the wrist joint. It joins your forearm bones together and connects the bones in the hand to the wrist.
When the TFCC is injured or torn, this affects the ability of the wrist to bear weight. A TFCC wrist injury can range from mild to severe and can even disable the wrist.
What Causes a TFCC Tear?
A TFCC tear or injury is usually caused by participating in high-impact sports, doing heavy-duty labor with your hands, or falling on an outstretched hand or arm. Athletes involved in sports that place a high demand on their hands, such as tennis, baseball, football, and gymnastics, are often most at risk for a TFCC injury.
There are two different types of TFCC tears:
- Traumatic TFCC Tears: This acute injury results from falling on an outstretched hand or suffering a blow to the wrist.
- Degenerative TFCC Tears: This usually occurs over time as the cartilage in the wrist wears down. Repetitive motions are usually the cause of degenerative TFCC tears.
What Are the Symptoms of a TFCC Tear?
Some common symptoms of a TFCC tear include:
- Persistent pain at the base of the wrist on the side of the pinky finger (ulnar wrist pain) that gets worse with movement or when bearing weight
- Swelling at the wrist
- Tenderness in the wrist
- A clicking sound in the wrist (crepitus)
- A loss of grip strength
- Difficulty rotating the forearm
- Difficulty performing simple activities such as opening a doorknob or putting a key in the door
How is a TFCC Tear Diagnosed?
Early diagnosis of a triangular fibrocartilage complex (TFCC) tear is critical to prevent additional hand, wrist, and forearm injuries.
To accurately diagnose a torn TFCC, your healthcare provider will ask you how the injury came about to determine whether it was a traumatic or degenerative injury. Your doctor will then determine the severity of your injury.
Your doctor may conduct joint stability tests such as a hyper supination test and an ulnar deviation test. A hyper supination test is performed by rotating your arm in a palm-up position. An ulnar deviation test is performed by moving your hand away from your thumb (wrist extension).
In addition to performing a physical exam, your doctor may also order different imaging tests, such as an X-ray or an MRI, to come to an accurate diagnosis and rule out any other conditions. X-rays give a clearer picture of the wrist bones and rule out potential wrist fractures. MRI scans create images of soft tissues and show the extent of the torn tissue.
As soon as your doctor has a clear idea of the injury, they will recommend the appropriate treatment.
What Are the Treatment Options for a TFCC Tear?
Triangular fibrocartilage complex (TFCC) tears that are mild to moderate in severity can usually be treated nonsurgically. Conservative treatments used for minor TFCC tears include:
- Resting the wrist
- Taking anti-inflammatory medication
- Corticosteroid injections
- Wearing a splint or cast to immobilize the wrist for 4 to 6 weeks to prevent further injury
- Physical therapy
In some cases, severe TFCC injuries may require surgery. Surgical treatment is often required in the case of a ligament rupture in the hand.
Many surgeons use the wrist arthroscopy technique that involves small instruments to visualize the structures and operate inside the wrist joint. After surgery and recovery, your doctor might prescribe physical therapy for several weeks to restore flexibility and mobility to the wrist.
TFCC Treatment in Ohio
Our board-certified hand, wrist & elbow specialists at OrthoNeuro are skilled in treating ulnar-sided wrist pain. We have helped many patients recover from TFCC tears and other various injuries to the wrist and have enabled athletes and non-athletes alike to begin the healing process as soon as possible.
If you have had a recent wrist injury and would like to know if you have a TFCC tear, make an appointment for a physical examination with an OrthoNeuro specialist today! We have multiple locations in Columbus, Ohio.
FAQs About TFCC Tears
What causes a TFCC tear?
A TFCC tear may occur after a fall onto an outstretched hand, a direct blow to the wrist, or activities that place repeated stress on the joint. Sports such as tennis, baseball, football, and gymnastics can increase the risk. Tears may also develop gradually as the cartilage wears down over time.
What are the symptoms of a TFCC tear?
Common symptoms include pain on the pinky-finger side of the wrist, swelling, tenderness, and clicking during movement. Some people also experience weaker grip strength or difficulty rotating the forearm and performing everyday tasks, such as opening a door.
How is a TFCC tear diagnosed?
An orthopedic specialist will review how the injury occurred, assess wrist pain and movement, and perform physical examination tests to evaluate joint stability. X-rays may help rule out other problems, while an MRI can help identify damage to the TFCC and surrounding structures.
Can a TFCC tear heal without surgery?
Yes. Mild to moderate TFCC tears can often be managed without surgery. Treatment may include resting the wrist, wearing a splint or cast for four to six weeks, taking anti-inflammatory medication when appropriate, receiving a corticosteroid injection, and attending physical therapy.
When is surgery needed for a TFCC tear?
Surgery may be considered when the injury is severe, or symptoms do not improve with nonsurgical treatment. The appropriate procedure depends on the location and extent of the damage. After surgery, physical therapy may help restore wrist flexibility, strength, and mobility.