Triangular Fibrocartilage Complex Tears

TFCC Tear Specialist in Dallas, Texas

The triangular fibrocartilage complex, or TFCC, is an area of cartilage, tendons, and ligaments that keeps the forearm and wrist bones stable when the hand grasps or when the forearm rotates. An injury or tear, hinting the name, TFCC tear, in this area is likely to cause chronic wrist pain.

Anatomy

The triangular fibrocartilage complex is a cartilage structure that exists between your radius and ulna, the two bones of the forearm. It is made up of several ligaments and tendons, along with cartilage. It helps stabilize the bones of your forearm and wrist whenever your wrist or forearm moves, and cushions the small bones in the wrist. 

TFCC Tear Causes

There are two types of TFCC tears, which differ depending on what caused the injury:

Type 1 TFCC Tear

These types of TFCC tears are caused by trauma or injury to the wrist area. For instance, falling on your outstretched hand could cause damage to the TFCC. 

Type 2 TFCC Tear

This type of TFCC is not caused by trauma, but rather by the slow wear and tear of the tendons, ligaments, and cartilage that make up the TFCC. These types of tears usually result from an underlying condition like arthritis or gout.

Many athletes who regularly rotate or place pressure on their wrists have a higher risk of developing a TFCC tear. Some athletes with a high risk of injury in this area are gymnasts and tennis players.

If you have injured your wrist in the past, you are also at a higher risk for a TFCC tear. 

TFCC Tear Symptoms

The most common and prominent symptom of a TFCC tear is pain on the outside of the wrist, though it is possible to experience pain throughout the entire wrist. The pain could be constantly present, or could only appear when moving or placing pressure on the wrist. 

Other common symptoms include:

  • A clicking or popping sound when you move your wrist
  • Instability when moving the wrist
  • Swelling in the wrist and lower forearm
  • Weakness
  • Tenderness

TFCC Tear Diagnosis

TFCC tears are typically diagnosed using a test called the fovea test, or the ulnar fovea sign. During this test, your doctor will place pressure on the outside of both your injured and uninjured wrist, and ask if you feel any pain or tenderness in the injured wrist. 

Your doctor may also ask you to rotate your forearm or to hold your thumb stable while moving your hand. X-rays can also be used to ensure the injury is not more serious, like a broken bone in the hand or forearm.

TFCC Tear Treatment

TFCC tears are treated both surgically and non-surgically, depending on the severity of the injury.

Nonsurgical treatment involves ceasing all activities that cause pain in the injured wrist, allowing the tear to heal. Your doctor may advise you to wear a cast or a brace to prevent excessive movement in the wrist. 

Physical therapy is also helpful when rebuilding strength in the TFCC. A physical therapist can recommend gentle exercises to strengthen the tendons and ligaments there without irritating the injury.

If your injury is particularly severe, or if nonsurgical treatments do not work for some other reason, surgery may be necessary. The surgery used to repair a TFCC tear is a minimally invasive procedure where the doctor will make small incisions in the wrist to repair the TFCC.

Post-surgery, you will likely need to wear a cast for approximately six weeks. Physical therapy will also potentially be necessary post-operation.

TRCC Tear Recovery

A TFCC tear that does not require surgery typically takes approximately four to six weeks to fully recover from. Surgical repair will take longer, usually anywhere from six weeks to several months. Adhering to your treatment plan and engaging in appropriate physical therapy is the key to achieving a full recovery.

There are various exercises you can do at home throughout your day that are recommended to strengthen the TFCC during recovery:

  • Moving your wrist in a circular direction, counterclockwise and clockwise
  • Stretching your wrist back toward your forearm, and then forward in the opposite direction
  • Flexing your wrist against a hard surface
  • Repeatedly gripping a tennis ball

It is best to start these exercises off slowly, so as not to overexert your wrist too early. Your doctor will discuss with you your specific injury and any restrictions.

The vast majority of people recover completely from a TFCC tear, though in some cases, it is not uncommon to have stiffness or pain in the wrist for several years afterwards. Work with your doctor to manage this pain. You may need to wear a brace during certain activities, or schedule more physical therapy.

At SPORT, our orthopedic providers can help relieve the pain of a hand or wrist injury and restore your flexibility and range of motion. For an appointment at our Dallas or Frisco office, call (469) 200-2832 today or use our convenient online appointment request form.

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