The triangular fibrocartilage complex (TFCC) is a cartilaginous structure in the ulnar side (little finger side) of the wrist that helps to provide stability. It is made up of ligaments, tendons, and cartilage that allows the wrist. A TFCC tear occurs when one of these structures is injured, causing pain, instability, clicking and loss of function in the wrist.
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TFCC tears can affect people of all ages, but they are most common in adults between the ages of 30 and 60. They are more common in people who participate in activities such as contact sports, manual labour, or playing musical instruments.
The main symptoms of a TFCC tear include:
A TFCC tear is typically diagnosed based on a physical exam and the patient's medical history. The doctor will ask about the patient's symptoms and activities. The doctor will also examine the wrist for pain, tenderness, and range of motion limitations. A grind/crank test describes placing of the hand and wrist in a position to compress the TFCC and then rotating the forearm which may reproduce painful clicking.
Imaging tests, such as an MRI may be useful to definitively diagnose a TFCC tear and to rule out other causes of little-finger sided wrist pain such as an ECU tendon problem. Ultrasound is not diagnostically definitive for a TFCC tear.
Contact Us 020 8004 6659Treatment for a TFCC tear depends on the severity of the injury. Non-surgical treatments are often effective for mild to moderate TFCC tears. Non-surgical treatments may include:
At The Joint Injection Clinic, these injections are performed after a thorough consent process, whereby the risk and benefits of the procedure are discussed in detail with your doctor. The experienced medical doctor will then place you in a seated position with your hand resting on the couch. The hand is cleaned using a cleaning solution to ensure that the procedure is performed under sterile conditions. The combined local anaesthetic and steroid is injected from the skin to the joint under ultrasound guidance.
The injection itself is normally completed within 30 seconds, after which a plaster is applied and post-injection advice is given. The patient is advised to look out for any signs of infection, specifically to check whether the local area becomes red, hot, tender, swollen or if they develop a fever. If this occurs then the patient is asked to contact the clinic immediately at which time a formal reassessment will occur and if needed oral antibiotics can be prescribed. The patient is also warned that following this particular injection they may notice a short-term worsening or flare in their symptoms after the local anaesthetic has worn off (4-5 hours). This may last for 3-5 days and the patient is advised to consider icing of the area using an ice pack for 10-15 minutes every hour as required.
If non-surgical treatments are not effective, surgery may be an option. Surgery for a TFCC tear may involve:
Additional tips for managing TFCC tear pain:
If you are experiencing pain, instability, or loss of function in your wrist, it is important to see a doctor to get a diagnosis and discuss treatment options. With early diagnosis and treatment, most people with TFCC tears can recover fully and return to their normal activities.
