The triangular fibrocartilage complex (TFCC) is a structure that supports the carpal bones in the wrist. The TFCC is made of tough fibrous tissue and cartilage that supports the joints between the end of the forearm bones (radius and ulna). The triangular fibrocartilage complex supports the wrist by keeping the radius and ulna stable when the hand grasps an object or the forearm rotates. The TFCC acts as a cushion between the end of the ulna and small bones of the wrist.
Injuries to the triangular fibrocartilage complex are common due to the complexity of the structure. A triangular fibrocartilage complex tear can occur from a traumatic injury, excessive use, or natural aging. Cartilage tears can cause chronic wrist pain. A triangular fibrocartilage complex tear may not cause any pain or instability problems in a wrist, but others may experience painful symptoms including weakness and limited motion. There are two types of triangular fibrocartilage complex tears. Type 1 tears occur when a person falls on an extended hand or over-rotates the wrist. Tears from injury can come from falling, twisting, or fractures. Type 2 tears occur gradually over time due to natural wear from an underlying condition such as rheumatoid arthritis. Tears are most commonly due to wear and uncommon in younger patient population. MRI is the best test to diagnose TFCC because the scan reveals the extent of the injury to the tissue and cartilage.
The most common symptom of a triangular fibrocartilage complex tear is pain on the outside of the wrist. Other symptoms of TFCC include wrist stiffness, weakness, swelling, popping, clicking, or reduced range of motion. While anyone can develop triangular fibrocartilage complex tears, people at higher risk include over 50 years of age, suffer from chronic inflammation, use a racquet or club. If someone is experiencing pain or instability in the wrist, it may be a sign of a problem with the triangular fibrocartilage complex.
Triangular fibrocartilage complex problems can be treated with ice the joint, compress, rest, and over-the-counter NSAID medication for pain or swelling. Triangular fibrocartilage complex tears that do not require surgery can take as long as 12 weeks to heal. Triangular fibrocartilage complex problems can be prevented by avoiding repetitive and excessive wrist motion.
When conservative treatments are not effective, the wrist may need to be braced or casted, along with physical therapy to strengthen the wrist and improve the range of motion. Other treatment options that may give relief are splints, injections, and activity changes.
The last line treatment option is minimally invasive arthroscopic surgery. The surgery will repair the damaged area through a series of incisions along the wrist. If surgery is required, the doctor will prescribe a brace to immobilized the wrist for up to six weeks after surgery. The tear can take as long as three months to fully heal after surgery.
If you have sustained a wrist injury, schedule an appointment with an orthopedic specialist as soon as possible.