Triangular Fibrocartilage Complex (TFCC) Tears

Overview

This condition is a degenerative or traumatic tear of one or more parts of the triangular fibrocartilage complex (TFCC), which stabilizes the ulna. The TFCC is composed of a group of ligaments that form connections between the radius, ulna and the carpal bones of the hand. At the center of these ligaments lies the most commonly injured structure, the triangular fibrocartilage disc, which is connected between the radius and the base of the ulnar styloid.

Causes

TFCC tears are often caused by degeneration through normal use of the wrist as we age. Overuse of the wrist with activities such as gardening or handling heavy luggage may further aggravate or tear the degenerative tissue. Traumatic tears may be caused by falling onto an outstretched hand, forceful twisting of the wrist and occasionally by a sharp blow to the outside of the wrist. The TFCC can also become torn during certain athletic activities, such as swinging a baseball bat, a tennis racquet or a golf club.

Symptoms

The primary symptom of a TFCC tear is pain on the ulnar side of the wrist. The pain may be accompanied by clicking, popping, catching or snapping when the wrist is rotated.

Diagnosis

Radiographs are used to evaluate the injured wrist. An MRI arthrogram, in which contrast dye is injected into the wrist joints during the MRI, may also be needed. If the physician cannot make a clear diagnosis using those methods, wrist arthroscopy may be used to look inside the wrist.

Treatment

Treatment options include rest, icing and anti-inflammatory medications for mild symptoms. A wrist brace, splint or cast may be used to prevent motion as the inflammation subsides. A corticosteroid injection may also be used to relieve inflammation. In severe cases with persistent pain or instability, surgery may be required to debride or repair the tear.



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