Triangular Fibrocartilage Complex Tear (TFCC)

What is a TFCC tear?

Your wrist is one of the most complex joints in your body, with 15 bones connecting the forearm and the hand together. The Triangular Fibrocartilage Complex (TFCC) is a collection of cartilage which is located in your wrist, and trauma to this important structure can severely limit the use of your wrist. A TFCC tear is sometimes known as a wrist sprain.

There are a number of ways that you can tear your TFCC. Often, injury can occur following general wear and tear and you are more likely to suffer from a TFCC tear if you are older. However, you can also tear your TFCC by any of the following:

Falling onto the hand/wrist, especially if your arm is stretched out
Twisting the wrist
Fracturing your radius may also cause a tear to your TFCC as the tissue that it is made from is connected to your bones

You may be more likely to tear your TFCC if you are a gymnast and using power tools, which can also cause you to sustain an injury. It may be that you don’t actually experience any pain with a TFCC tear and can carry on using your wrist as normal, however, if left untreated the injury can become worse over time.

If you have a TFCC tear, you may initially feel pain throughout your entire wrist. You may also suffer from the below:

A clicking or popping sensation
Unable to move the wrist in full motion
Weakness in the wrist

If you are suffering from any of the above, you should see your GP or a consultant.

Diagnosis

To diagnose a TFCC tear, you will be asked to move your wrist in certain ways to ascertain when and where you feel pain. They will also perform a test called the ‘unar fovea test’, which involves them squeezing your wrist and asking you to confirm whether you feel any pain or tenderness. They will normally do the same to your other wrist so that they can compare the sensation. If necessary, you may be referred for an x-ray or an MRI scan to confirm the diagnosis.

Non-surgical treatments

If you are found to have a TFCC tear, there are a number of non-surgical options available which may be suggested to treat the tear.

Your consultant may advise that you keep your wrist as rested as possible and may also provide a splint to help you to keep your wrist as still as possible, they may also suggest a program of gentle exercises that you can do to help rebuild the strength. These include trying to grip an object such as a tennis ball and moving your wrist in a gentle circular motion. You should do these exercises with caution to ensure you don’t overwork the wrist and make the tear worse.

For any pain, over the counter inflammatory medications such as ibuprofen or aspirin should help. They may also suggest physiotherapy over the next few weeks to help with rehabilitation.

Surgical treatments

If you are still experiencing pain and discomfort, you may need surgery to repair the tear. At North West Hand Clinic, we can perform a procedure called an arthroscopy. This is usually performed under a local anaesthetic and takes around 30 minutes to an hour.

A small camera called an arthroscope is inserted into small incisions made into the skin in the back of your wrist, allowing us to see inside your joints on a monitor screen. We will then be able to repair the joint and remove any damaged tissue. As this is what is known as ‘keyhole’ surgery there is minimal risk associated and the problem can usually be fixed there and then, and in most cases, you can go home the same day as your procedure.

Your recovery

Your recovery is dependent on how extensive the treatment carried out during your arthroscopy was, however on average this can take about six weeks. Your wrist may be very tender and swollen following your surgery, however this should settle down after around three weeks. You can take paracetamol to help manage any pain you may be experiencing. You should try to keep your wrist rested and elevated as much as possible.

We will make a follow up appointment to see you two weeks following your surgery. A treatment plan will be devised and we will advise on any exercises or physiotherapy you may need to help with your rehabilitation. Depending on the type of work you do, we will advise on when it is safe for you to go back to work.

Whatever your hand or wrist condition is, we can help.

Mr Randeep Mohil provides clinics across Lancashire and Cheshire.

Please call us on 01625 466158 or email info@northwesthandsurgeon.co.uk

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Lancashire Clinics

The Beardwood Hospital, Blackburn
Clinic days: Monday evenings (alternate) and Thursday mornings
Website: The Beardwood Hospital
Ramsay Fulwood Hospital, Preston
Clinic days: Monday and Tuesday evenings (alternate)
Website: Ramsay Fulwood Hall

Ramsay Euxton Hall Hospital, Chorley Clinic days: Tuesday evenings (alternate) Website:Ramsay Euxton Hall

Cheshire Clinic, Northwich Clinic days: Friday morning (alternate) Website: The Cheshire Clinic

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Triangular Fibrocartilage Complex Tear (TFCC)

What is a TFCC tear?

Diagnosis

Non-surgical treatments

Surgical treatments

Your recovery

Whatever your hand or wrist condition is, we can help.

Get in touch