What are TFCC and Ligament Injuries?
The TFCC, triangular fibrocartilage complex, helps stabilize the distal radioulnar joint. It is made up of several ligaments and cartilage. There is a small articular disc in the center of the complex that cushions the wrist. Injury to the TFCC involves tears of the articular disc and/or surrounding ligaments. This injury can occur as a result of an accident, falling onto an outstretched hand, high-demand athletes with repetitive wrist hyperextension, and degenerative changes. Patients with ulnar variance, meaning the ulnar is longer than the radius are also more predisposed to TFCC injuries.
Pain is usually localized to the small finger side of the wrist although in some cases it is more diffuse. It is usually aggravated by any type of forearm rotation. Sometimes patients may feel instability or catching inside the joint.
Tears are diagnosed by a combination of history, clinical testing, and MRI usually with contrast. There are different grades of tears, but treatment usually begins conservatively with immobilization and possibly cortisone injections. If the patient’s symptoms have not improved with conservative management or the patient is experiencing instability they may be indicated for an arthroscopic TFCC debridement or repair. The recovery usually involves a period of immobilization followed by physical therapy to regain mobility and strength.