What is triangular fibrocartilage complex (TFCC) tear or sprain?
A triangular fibrocartilage complex (TFCC) tear or sprain occurs when the triangular fibrocartilage complex (TFCC), a cartilage structure that joins the end of the forearm to the small wrist bones on the pinkie side, is strained due to an injury or a golf swing.
The triangular fibrocartilage complex consists of the triangular fibrocartilage disc, ulna meniscus, ulnar collateral ligament, carpal ligaments and the extensor carpi ulnaris tendon sheath. Its function is to provide stability, cushioning and smooth movement in the wrist joint.
Types of triangular fibrocartilage complex (TFCC) tears or sprains
Triangular fibrocartilage complex (TFCC) tears are categorized as traumatic (Type 1) and degenerative (Type 2).
- Type 1 triangular fibrocartilage complex tears occur because of a traumatic fall or injury to the wrist.
- Type 2 triangular fibrocartilage complex tears occur because of continual use and more gradually develop.
Causes of triangular fibrocartilage complex (TFCC) tears or sprains
There are many causes of triangular fibrocartilage complex (TFCC) tears or sprains including:
- Falls — triangular fibrocartilage complex (TFCC) tears can occur if someone falls on their outstretched hand
- Inflammatory disorders such as gout or rheumatoid arthritis can contribute to Type 2 triangular fibrocartilage complex tears
- Sports that require forceful twisting or pulling movements
Risk factors for triangular fibrocartilage complex (TFCC) tears or sprains
Risk factors of triangular fibrocartilage complex (TFCC) tears or sprains include:
- Athletes — athletes who use a bat, golf club, racquet or those who put excessive pressure on their wrists (gymnasts) are at higher risk for suffering from a triangular fibrocartilage complex (TFCC) tear or sprain
- Age — people over the age of 50 are more likely to develop a triangular fibrocartilage complex (TFCC) tear or sprain
- Longer ulna bone — people with a longer ulna are at higher risk to injure their triangular fibrocartilage complex
Symptoms of triangular fibrocartilage complex (TFCC) tears or sprains
The most common symptoms of a triangular fibrocartilage complex (TFCC) tear or sprain are pain and a clicking noise when the wrist is moved in certain directions. Other symptoms of a triangular fibrocartilage complex (TFCC) tear or sprain include:
- Loss of grip strength
- Swelling in the wrist
- Pain when the wrist is bent from side to side
- Sudden onset wrist pain
Diagnosis of triangular fibrocartilage complex (TFCC) tears or sprains
An orthopedic physician will diagnose triangular fibrocartilage complex (TFCC) tears or strains in an in-depth a physical exam of the wrist. In order to rule out more serious conditions such as wrist fractures, a physician may order an x-ray or an MRI.
An MRI test is the most reliable test to diagnose triangular fibrocartilage complex tears/strains. The MRI will be able to look at the tissues or cartilage to determine the extent of the damage in the wrist. If the imaging results are inconclusive, the physician may use an arthroscope to see inside the joint.
Treatments for triangular fibrocartilage complex (TFCC) tears or sprains
Triangular fibrocartilage complex (TFCC) tears or strains can be treated with anti-inflammatory medications. Most cases of TFCC tears or strains can be treated with conservative measures. If the injury is more severe, other treatments for triangular fibrocartilage complex (TFCC) tears or strains include:
- Splint/brace
- Steroid injection
- Arthroscopic debridement
- Physical therapy & rehabilitation
- Platelet rich plasma (PRP) injection
Recovery from triangular fibrocartilage complex (TFCC) tears or sprains
Recovering from triangular fibrocartilage complex (TFCC) tears or sprains is dependent upon the severity of the injury.
Most triangular fibrocartilage tears will be healed within eight to 12 weeks. In some cases, the symptoms lessen even if the injury has not healed.
If you have had surgery or a cast put on the wrist, physical therapy is typically indicated to strengthen the wrist. Physical therapy will help the patient achieve full function of the hand or wrist.