Wrist Triangular Fibrocartilage Tear (TFCC)

Triangular fibrocartilage complex (TFCC) injuries of the wrist affect the little finger side of the wrist. The TFCC lies between the ends of the two forearm bones. It is triangular in shape and made up of several ligaments and cartilage.

The TFCC makes it possible for the wrist to move in six different directions (bending, straightening, twisting, side-to-side and rotation in either direction). Injuries are usually in the form of a tear. A traumatic injury or a fall onto an outstretched hand is the most common cause of injury, but athletes such as tennis players or gymnasts are also at risk for TFCC injuries.

Symptoms

The symptoms of a TFCC tear include:

  • Pain along the little finger side of the wrist
  • Clicking or popping of the wrist
  • Pain with activity or rest

Diagnosis

The diagnosis of this problem is based on a physical exam and MRI of the wrist. X-rays should be done to rule out fractures of the bones.

Treatment

The first treatment option involves stopping the activities that cause pain and using a splint, or cast, to immobilize the wrist. After four to six weeks, physical therapy can be started. The therapy can usually be completed in six weeks, and your child can return to his or her activities.

If conservative management fails to restore function and decrease pain, surgery can be considered. Surgery is usually done with arthroscopy, and the tear is either repaired or removed depending on the location and the quality of the tissue. Bracing and therapy are recommended after the surgery. Unfortunately, although most athletes report improvement in their symptoms, many will have some mild residual pain in their wrist during sports.