TFCC (Triangular Fibro Cartilage Complex) Injury
By Reece Jones
Do you have pain in your wrist?
If you have pain at the base of your little finger at the wrist, it could be due to an injury to the Triangular Fibro Cartilage Complex (TFCC).
Quick tests to assess your TFCC:
Place your palm under a table and attempt to lift the table up.
If you have pain or a clunk is felt, this may indicate damage to the TFCC.
What is the TFCC:
It is structure made up of ligaments, a meniscus, a fibro-cartilage disc and a wrist extensor muscle. This binds to the ulna and radius (2 bones in your forearm) and the small bones in the hand. It’s role is to provide stability to the joints of the wrist and hand. It also allows force to be transferred and allows an individual to perform complex wrist movements.
There are two types of ways you can damage the TFCC:
Type 1 tear: Traumatic tears such as falling onto an outstretched wrist with a rotated wrist
Type 2 tear: Degenerative or chronic tear where the cartilage is worn down over time from overuse.
Signs and Symptoms:
There are a variety of mechanisms that may cause an injury to the TFCC. These include falling onto an outstretched hand with the wrist twisted or completing repetitive wrist movements in sport or at work. Signs and symptoms include pain and/or swelling at the base of the little finger at the wrist. This pain is often worse with rotation of the wrist such as a twisting motion when you turn a key, or when the wrist goes side to side. You may find your grip is weakened or a clunk may be heard when rotating the wrist.
Non-surgical Treatment of a TFCC injury:
If the wrist is considered stable by the physiotherapist, a splint is made to allow the ligamentous structure to heal. Strengthening exercises for the muscles that lift the wrist up are often prescribed once the structure has healed. Other treatment options include a cortisone injection or possibly surgery if conservative management fails. The structure does however have a poor blood supply, making it difficult to heal and therefore it is important it’s not missed.
In the less severe cases , the use of specific splints such as the Widget Splint demonstrated here can offer relief of symptoms and improve function.