Many of our patients discover through direct experience that the wrist is a versatile but complex joint. For the hands to work as they do, the wrist must provide strength, flexibility, and space. To achieve this, the wrist has eight small bones in a joint that attaches to the ulna and distal radius of the arm. The bones of the wrist and arm are connected via ligaments, some of which are more prone to injury than others. One of those ligaments is the triangular fibrocartilage complex, or TFCC.
The TFCC is situated on the outside of the wrist near the pinky finger. The role this ligament plays is to stabilize the ends of the distal radius and ulna when the hand is gripping, or the forearm rotates. For example, it is the TFCC that is at work when you carry a gallon of milk to the refrigerator. The TFCC enables you to use a can opener and brush your hair. The triangular fibrocartilage complex is only about the size of a dime, but it packs a punch if injured. If the TFCC suffers an injury such as a tear, chronic pain may result.
Causes of TFCC Injury
The TFCC may suffer an acute or chronic injury. A common injury to this ligament is falling on an outstretched hand. Conversely, the ligament may tear as a result of frequent use that requires forearm rotation. A chronic tear is a gradual injury that involves degeneration of the fibrous structure over time. In some instances, the TFCC ligament gets pinched due to the excessive length of the ulna bone, ultimately resulting in a hole being worn through the ligament. Finally, a degenerative tear may coincide with chronic an inflammatory disorder such as rheumatoid arthritis.
Many cases of wrist pain can be attributed to a torn TFCC ligament. If pain occurs in the outside area of the wrist when gripping or rotating action is performed, treatment may be needed to allow the ligament to repair itself.
Treating the TFCC Injury
When possible, conservative treatment is prescribed for TFCC tears. This includes short-term activity modification, use of anti-inflammatory medication, and likely splinting to immobilize the wrist. In some instances, though, surgery may be necessary for optimal repair. The technique used to repair injury to the TFCC ligament is determined by the exact location of the tear. A comprehensive consultation is performed to identify relevant factors guiding the surgical procedure.
After TFCC surgery, motion and strength typically return right away. However, a wrist splint is usually worn for up to six weeks postoperatively. After this time, strength exercises may begin.