The TFCC, or the Triangular Fibro-Cartilaginous Complex, is made up of a cartilage disc that sits over the end of the ulna (the bone in the arm). This provides a smooth surface between the radius and ulna, and a group of ligaments that hold the radius and ulna together, or the Distal Radio-Ulna Joint (DRUJ). The TFCC is what stabilises the radius and ulna joint within the wrist.
A TFCC tear can occur as a result of an injury to the wrist, such as a fall onto an outstretched hand, or from everyday wear and tear to the joint. Damage to the TFCC is quite common due to the wrist being a very complex mechanism with an extensive range of movement.
TFCC Tear Symptoms
The symptoms of a TFCC tear include pain mainly on the outside of the wrist, over the prominent ulna bone, although pain may also radiate through the wrist. The pain is commonly experienced when the joint is used often, and resting will usually ease the painful symptoms. Rotating the wrist or moving the wrist outwards is also likely to cause pain. There may also be swelling around the outside of the wrist and patients often report a loss of strength in the wrist, especially when trying to perform twisting or gripping actions. Clicking, cracking, or grating sounds within may also be apparent upon movement of a wrist with a TFCC tear.
If a TFCC tear is present but there is no instability of the radio-ulna joint, then non-surgical treatment will be attempted. A splint may be worn, sometimes for four to six weeks. This keeps the joint immobile and allows the wrist time to rest and repair itself. Anti-inflammatory drugs may also be prescribed to help reduce any swelling and ease pain in the joint. Steroid injections may also be required to ease painful symptoms.
If conservative treatment is unsuccessful, then surgery may be required. Surgery may involve an arthroscopic procedure. Mr Durrant inserts a narrow camera through a small incision into the wrist, and any torn and damaged cartilage or frayed ligament tissue is removed. The torn ligament may also be repaired by using sutures to close up the tear. If the damaged ligaments are unable to be joined together with sutures, a reconstruction of the ligament may be necessary. To prevent the injury occurring again Mr Durrant may shorten the ulna by taking a small piece of bone out to “decompress” the wrist joint.
Contact Mr. Adam Durrant for more information on TFCC tears or for additional resources on other wrist related injuries.