Triangular Fibrocartilage Complex (TFCC) Tear Treatment
The Triangular Fibrocartilage Complex (TFCC) is a group of ligaments, tendons, and cartilage located on the small finger side of the wrist. It stabilizes the wrist, cushions forces, and allows smooth rotation. Injury to the TFCC can cause pain, weakness, and limited wrist movement, often requiring medical care.
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Find Relief TodayOverview
The wrist carries out complex movements, rotating, bending forward, backward, and side to side, while maintaining a stable link between the forearm and hand. The Triangular Fibrocartilage Complex (TFCC), situated between the radius and ulna, enables these motions.
This structure, made of ligaments and cartilage connecting the forearm to the wrist, can tear from overuse, sudden injury, or gradual tissue wear, varying from mild to severe.
What causes Triangular Fibrocartilage Complex (TFCC) Tear?
TFCC tears are frequently seen in athletes who engage in repetitive wrist movements, such as gripping or swinging equipment like a baseball bat, racket, or golf club. These tears may also result from traumatic injuries, such as falling on an outstretched hand. Age-related wear and tear can further weaken the wrist ligaments, increasing susceptibility to injury.
- How the Injury Occurs: A TFCC tear typically happens when the wrist is forced into extreme rotation or when a heavy load is placed on it during movement. This can occur suddenly (as in a fall) or gradually through repetitive strain.
- Common Everyday Causes: Activities such as using power tools, carrying heavy grocery bags, or twisting jar lids can also cause TFCC damage over time, especially if the wrist is weakened or overused.
Common Sports Linked to TFCC Tears:
- Baseball: Repeated bat swings and high wrist torque can strain the TFCC over time.
- Racket Sports (e.g., tennis, racquetball, squash): Constant wrist rotation and impact during serves and volleys may lead to small tears.
- Golf: The forceful twisting and impact of the club hitting the ground can injure the TFCC.
- Hockey: Sudden wrist flexion during shooting or falls on the ice can stress the wrist complex.
Symptoms
Individuals with a Triangular Fibrocartilage Complex (TFCC) tear often feel pain on the wrist’s ulnar (pinky finger) side. The pain can be persistent or appear only during certain movements or activities. Other common symptoms include:
- Weakness when gripping, lifting, or holding objects.
- Tenderness along the ulnar side of the wrist when touched.
- Swelling may develop around the wrist joint.
- Limited range of motion, making it difficult to rotate or bend the wrist fully.
Wrist clicking sounds during wrist movement are often accompanied by discomfort.
When to see a doctor
If you experience symptoms of a TFCC or wrist cartilage tear, it’s essential to consult a doctor. During the evaluation, your doctor will discuss how the injury occurred, your activity level, and any sports you play. A physical examination will follow for tenderness, swelling, or restricted movement.
If a TFCC tear is suspected, the doctor may gently press on certain wrist areas and guide your wrist through specific motions to assess pain and stability. Imaging tests like X-rays or MRI scans may also be recommended to view the wrist’s bones and soft tissues, confirm the diagnosis, and rule out other possible causes of ulnar-sided wrist pain or instability.
Non-operative treatment
The treatment approach for a TFCC tear depends on the tear’s severity, location, and whether wrist instability is present. In most cases, TFCC injuries can be managed without surgery. Non-operative or conservative care usually includes:
- Rest from activities that strain or twist the wrist.
- Ice therapy to reduce swelling and discomfort.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, ease pain and inflammation.
- Wearing a splint or cast for several weeks to immobilize and support the wrist during healing.
- Cortisone injections, if necessary, to provide targeted pain and inflammation relief.
- Once healing begins, physical therapy is used to restore strength, flexibility, and wrist function.
Try these exercises to help address your condition:
Below is a PDF of the exercise program.
Surgical Treatment
Surgery may be recommended if the TFCC tear is severe, causes wrist instability, or does not improve with conservative care. Most procedures use arthroscopy, a minimally invasive technique involving small incisions and a tiny camera that allows the surgeon to view and treat the injury precisely.
Depending on the damage, the surgeon may repair the torn ligaments or remove frayed tissue (a process known as debridement). Before surgery, discussing the potential benefits, risks, and recovery expectations with your surgeon is essential.
Recovery
Healing from a TFCC tear treated non-surgically usually takes about four to six weeks, while recovery after surgery can take several months. A structured rehabilitation program focusing on gentle movement, flexibility, and strength training is crucial.
With proper care and therapy, most athletes and active individuals can expect to return to full activity once strength and stability are restored.
Dr. Jay Kimmel is a board-certified orthopedic surgeon specializing in sports medicine, arthroscopic surgery, and shoulder and knee disorders. He completed his orthopedic training at New York-Presbyterian/Columbia University Medical Center and a Sports Medicine Fellowship at Temple University.
Dr. Kimmel previously served as the Director of the Connecticut Sports Medicine Institute at Saint Francis Hospital and has held faculty appointments as Clinical Assistant Professor in the Departments of Orthopedics and Family Medicine at the University of Connecticut. He has extensive experience caring for athletes as a team physician for high school and collegiate programs and continues to teach in the athletic training departments at Westfield State University and Springfield College.
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/MonthFrequently Asked Questions
What causes a wrist cartilage tear?
A wrist cartilage tear can result from repetitive stress, falls, forceful twisting, or age-related degeneration. Athletes and workers who use frequent wrist motions are more susceptible.
How do I know if I have a TFCC injury?
Symptoms include ulnar-sided wrist pain, clicking or popping during movement, wrist instability, and pain rotating the hand, for example, when turning a doorknob or opening a can.
Is a TFCC injury permanent?
Usually not. With timely treatment, whether conservative or surgical, many people recover fully; however, untreated tears can lead to chronic wrist instability and loss of function.
When should I see a doctor for ulnar-sided wrist pain?
If you experience persistent pain on the pinky side of your wrist, especially when moving your wrist or rotating your hand, consult a specialist to check for a TFCC or wrist cartilage tear.