Triangular Fibrocartilage Complex Injury

The triangular fibrocartilage complex (TFCC) is located on the ulna (little finger) side of the wrist. It is triangular in shape and is made up of several ligaments and cartilage that help support the wrist. It acts as a shock absorber and stabilizer for the wrist bones during twisting movements.

The main symptom of a TFCC injury is pain along the ulna side of the wrist. Though, sometimes the pain may be reported as diffuse; pain throughout the entire wrist. Any activity or position that involves forearm rotation such as opening a door handle, using a screw driver or a can opener can make the pain worse. Other symptoms include painful clicking, snapping, swelling, and reduced/weak grip strength. The wrist may also feel unstable or like it is going to “give way”.

A TFCC injury can be diagnosed through the history of your injury, symptoms, special tests performed by your osteopath or an MRI scan. Your doctor or osteopath may also give you a grading of your injury. This grade demonstrates the severity of the injury and how much damage has occurred to the ligaments and cartilage. Grade 1 is minimal, grade 2 is partial damage and grade 3 is a complete tear. There is also two different types of injuries. Type 1 is traumatic. This usually appears after a loading or twisting injury has occurred, such as falling on an outstretched hand or by a power drill whereby the drill binds and the wrist rotates instead of the drill bit. This type may also be associated with a fracture or dislocation to the wrist. Type 2 is degenerative. This appears if you have had long standing pain that has come about by either chronic overloading, previous wrist injury or a chronic illness such as gout or rheumatoid arthritis.

Treatment of a TFCC injury can include nonsurgical and surgical options. The first option includes wearing a splint for 4-6 weeks. This will allow the tissues to heal while being immobilized. Your osteopath will guide you through progressive strengthening and mobility exercises for another 4-6 weeks. During this time, anti inflammatories such as nurofen or voltaren may also be recommended. There is also other nonsurgical options if the injury may be taking longer to heal than normal or is quite unstable. These include cortisone injections or a cast. If the injury is more severe, surgery may be the next option.

Information compiled by Dr. Eliza Clark – Osteopath