Department of hand surgery & Microsurgery.

Tfcc Injury Wrist

The Triangular Fibrocartilage Complex (TFCC) is a structure that is made of cartilage and ligaments. It is located on the ulnar side of the wrist (side toward the little finger). The TFCC stabilizes the bones in the wrist, acts as a shock absorber, and enables smooth movements. The TFCC may be injured during a fall, sports, or on the job. An injured TFCC causes pain and may produce a clicking noise when the wrist is moved in certain ways. TFCC injuries are treated with anti-inflammatory and pain medication, splinting, casting, or surgery

Causes of TFCC injury

The cartilage and ligaments composing the TFCC are prone to degeneration and tearing. They do not have a good blood supply and therefore, injuries do not heal well. The TFCC can tear as the result of a wrist injury. The wrist can be injured during a fall on an outstretched hand. Forceful twisting and pulling movements can injure the wrist. This may occur in sports, such as when swinging a bat or hitting a ball with a racquet. These movements may also take place at work when using tools and equipment.

What are the Symptoms ?

TFCC injury causes wrist pain, particularly when moving your hand to the little finger side (ulnar deviation), or turning the wrist to face the hand upward (supination). Your wrist may feel weak and unstable. Your wrist may catch or not be able to produce smooth movements. You may hear a clicking noise when you move your wrist.

Diagnosis

Your doctor can diagnose TFCC injury by reviewing your medical history and examining your wrist. Imaging tests such as an X-ray or MRI scan will be ordered. An arthrogram may be conducted in conjunction with an X-ray. An arthrogram uses a dye injected into the wrist to outline the injured structures on an X-ray. Your doctor may use wrist arthroscopy (keyhole procedure ) to diagnose a TFCC injury when physical examinations or imaging scans are not conclusive.

Treatment

The treatment that you receive for a TFCC injury depends on your symptoms and the extent of your condition. Some injuries can be treated with protective supports, such as splints or casts. Arthroscopic surgery is recommended if nonoperative treatments will not or do not provide symptom relief.

Wrist Arthroscopy Surgery

The anesthesia necessary will be decided by you and your surgeon. Your surgeon will make a few small incisions near your wrist to insert the arthroscope and thin surgical instruments. The arthroscope is used to remove torn tissues or to repair the TFCC when possible. As arthroscopy uses small incisions and is less invasive than traditional surgeries, it has a shorter recovery time with less bleeding, swelling, and pain than open procedures. Open surgery for TFCC repair is becoming less common with the refinements in arthroscopic techniques.

Recovery

Recovery is very individualized and your doctor will let you know what to expect. Your recovery time will depend on the extent of your condition, how it was treated, and when it was treated. It is common to participate in hand therapy following surgery or cast treatment.