What is the TFCC?
The Triangular FibroCartilage Complex (or TFCC) stabilises the joint between the radius and ulna bones at the wrist. It is a complicated structure which has several key elements to provide support to the ulnar (or little finger) side of the wrist including a central disc area (like the meniscus in your knee) and peripheral ligaments and capsular attachments. The TFCC also acts as a cushion between the end of the ulna and small bones (lunate and triquetrum) of the wrist. In patients whose ulna is longer than the radius at the wrist, the TFCC is often thinner and can tear (ulnocarpal abutment syndrome).
How is it injured?
Tears from an injury can occur following a fall onto the outstretched hand, or from a twisting injury to the arm (such as when a drill bit catches). TTCC tears are often associated with fractures to the wrist. Sports such as golf, badminton and gymnastics often put the wrist in a certain position (of pronation) when gripping with force, which is thought to put more force through the TFCC area. This can lead to tears of the TFCC.
Treatment for TFCC:
- Taking anti-inflammatory medication (if appropriate), such as naproxen or ibuprofen or newer non-steroidal anti-inflammatory drugs (NSAIDS), or steroid injections to ease pain
- Casting or splinting to rest the wrist
- Hand Therapy (exercises to mobilise, strengthen tendons and ligaments in the wrist)
- Changing your hand’s position during activities/sport/work (ergonomic adjustment)
If the TFCC is torn it can either be repaired (if deemed suitable) or debrided (tidied up) with the aim of improving your symptoms of discomfort. The options of treatment will be tailored to your symptoms and underlying pathology and will be discussed in full with you at your consultation.