Triangular Fibrocartilage Complex Injury (TFCC)

Overview

A triangular fibrocartilage complex (TFCC) is a structure in the wrist that supports the carpal bones on the wrist. The TFCC is responsible for keeping the radius and ulna stable as the hand grasps an object or the forearm rotates. If this cartilage tears, you can experience chronic wrist pain.

Injuries to the TFCC are common due to the complexity of the structure.

Triangular fibrocartilage complex injury (TFCC) causes

A TFCC tear occurs from:

• Physical injury
• Excessive use
• Aging

There are two types of TFCC tears.

• Type 1 — Type 1 tears occur when a person falls on an extended hand, or when they over-rotate their wrist.
• Type 2 — Type 2 occurs gradually over time. Typically, type 2 tears result from an underlying condition such as gout or rheumatoid arthritis.

The type of TFCC tear will help guide your doctor’s treatment plan.

Triangular fibrocartilage complex injury (TFCC) symptoms

The most common symptom of a TFCC tear is pain on the outside of the wrist when it is touched or moved.

Other symptoms of TFCC include:

• Wrist stiffness or weakness.
• Reduced range of hand or wrist motion.
• Swelling in the wrist.
• Popping or clicking when moving the wrist.
• Reduced ability to grip objects.

Triangular fibrocartilage complex injury (TFCC) complications

If left untreated, a complete tear will lead to persistent instability.

Triangular fibrocartilage complex injury (TFCC) risk factors

While anyone can get TFCC, some people are at higher risk, including:

• People who are active and who use a racquet, bat, or club or gymnasts are at higher risk of developing a TFCC tear.
• People over 50 years old are more likely to experience a degenerative tear.
• Chronic inflammation. People with inflammatory conditions such as rheumatoid arthritis or gout can damage their wrists over time.

Triangular fibrocartilage complex injury (TFCC) prevention

TFCC can be prevented by avoiding repetitive, excessive wrist motions and by modifying movements that cause pain.

Triangular fibrocartilage complex injury (TFCC) diagnosis

Your doctor can diagnose a TFCC tear. During a clinic visit, your doctor will carefully examine your wrist and order imaging tests such as:

• X-ray
• MRI

An MRI is the best test to diagnose TFCC. MRI results can reveal the extent of the injury by allowing your doctor to inspect the tissue and cartilage.

Triangular Fibrocartilage Complex Injury (TFCC) Treatment

TFCC can often be treated with self-care including:

• Ice the joint for 10 minutes at a time.
• Compress the area with an ace bandage.
• Take an over-the-counter pain medication such as Ibuprofen or Naproxen for pain or swelling.

When conservative treatments are not effective, your doctor may recommend:

• Bracing, casting, or splinting your wrist.
• Prescription pain medication to reduce pain and swelling.
• Physical therapy to strengthen and stretch your wrist as well as improve your range of motion.

If you have persistent TFCC tears, your doctor may recommend minimally invasive surgery. The most common surgery used to treat TFCC is arthroscopy. During arthroscopy, your orthopedic surgeon will repair the damaged area through a series of incisions along the outside of the wrist.

When to Seek Care

If you have sustained a wrist injury, schedule an appointment with your doctor as soon as possible.

Next Steps

Before your clinic visit, take detailed notes of your symptoms, when they began as well as when they are most intense.

If diagnosed with TFCC, carefully follow your doctor’s treatment plan. If your symptoms worsen, call your doctor right away.

TFCC tears that do not require surgery can take as long as 12 weeks to heal.

If you have surgery to repair the TFCC, your doctor will prescribe a brace to keep the wrist immobilized for up to six weeks after surgery. A TFCC tear can take as long as three months to heal after surgery.