A TFCC tear is an injury to the triangular fibrocartilage complex, found in the wrist, between the end of the ulna bone and the carpals. Its function is to stabilize the radioulnar joint.
TFCC tear symptoms
Symptoms of a TFCC tear include wrist pain on the little pinky finger side. There will be tenderness over the back of the wrist. Pain is worst on bending the wrist sideways so the little finger moves towards the forearm ( called ulna deviation). There is likely to be swelling in the wrist, reduced grip strength and sometimes a clicking sound or feeling when moving the wrist.
TFCC tear explained
The triangular fibrocartilage complex consists of:
- The triangular fibrocartilage disc.
- Ulna meniscus.
- Ulnar collateral ligament.
- Several carpal ligaments.
- Extensor carpi ulnaris tendon sheath.
The function of this group of structures is to provide stability, cushioning and smooth movement at the wrist joint.
If a TFCC tear is suspected visit a Doctor, who will examine the wrist for signs and symptoms of the injury. They will perform some manual tests which place stress on the complex, looking for the symptoms to be reproduced. An MRI scan is most effective at diagnosing this particular injury with a 90% accuracy rate. An X-ray may also be used to rule out fractures. Once the extent of the injury is known, a decision can be made regarding the best treatment options.
A TFCC tear can be either traumatic from a specific injury, or degenerative. Traumatic injuries usually involve a compressive and twisting force and 50% of the time also result in a fracture of the Ulna or Radius. Falls onto an outstretched hand, with the palm down and wrist extended (bent backwards) are a common incident which may cause this injury.
Sports in which this injury is common include racket and bat sports like tennis and baseball and gymnastics due to weight bearing on the hands. Degenerative tears occur due to repetitive loading over a long period and are usually in the older population. They may also occur as a result of a genetically longer Ulna which pinches on the cartilage complex.
Treatment of TFCC injuries
In most TFCC tears, conservative treatment is successful. This involves immobilization in a splint for approximately 4 weeks. After this period a removable splint may be used which permits some movement. Anti-inflammatory medication such as ibuprofen may be prescribed. Electrotherapy such as ultrasound may be used. Progressive mobility and strengthening exercises as pain allows. A corticosteriod injection may be given in some cases.
Large tears, or degenerative injuries may require surgery. The procedure is usually done as an arthroscopy (key-hole). It involves trimming the torn piece of cartilage. In cases where the ulna is too long, the end of the bone may be shaved away. The wrist is then immobilised for 2-4 weeks. A rehabilitation programme should be followed after this period, to regain full strength, mobility and co-ordination.