Triangular Fibrocartilage Complex
What is the TFCC?
The TFCC (triangular fibrocartilage complex) is a cartilage structure located on the small finger side of the wrist, it consists of ligaments and tendons. The function of this group of structures is to provide stability and smooth movement of the wrist joint. The TFCC keeps the forearm bones, the radius and ulna, stable when the hand grips objects or when the forearm rotates. An injury or tear to this structure can cause chronic wrist pain.
Types of TFCC injuries
There are two types of TFCC injuries:
Acute injuries: this is a traumatic tear. This can result from a fall onto the hand or from excessive arm rotation.
Chronic injuries: this is a degenerative tear or a tear that has lasted a long time. This can occur due to repetitive loading over a long period.
Symptoms
The symptoms of a TFCC tear include:
Pain at the base of the pinky side of the wrist
Pain worsens as the wrist is bent from side to side, and any activity that requires forearm rotation produces pain. For example: turning a doorknob or a key in the door, or lifting a heavy pan with one hand.
Tenderness over the back of the wrist
Reduced grip strength
Sometimes a clicking in the wrist
How is it diagnosed?
TFCC tears are diagnosed through careful assessment of the wrist and forearm. This involves your physiotherapist determining how your pain began, looking at the location of your pain, and how your pain is affecting the movements of your fingers, wrist and forearm. From here your physiotherapist is able to implement a treatment program.
How is it treated?
Throughout your assessment your physiotherapist would have determined the likely cause of your pain, which movements are painful and which movements are affected by your injury.
If the wrist is still stable, conservative treatment is taken. This involves beginning to decrease inflammation and pain around the area. You may be given a splint to wear for a short period of time to assist in pain reduction, and activity modifications will be applied to movements which cause pain such as heavy grasping and turning and twisting the wrist. Your physiotherapist will assess how you perform daily tasks, so these activity modifications can be manageable in your every day life.
Once pain and inflammation have been controlled, the focus of treatment will be on strength and mobility of the wrist and hand. Mobility will be addressed by improving the bending and straightening of the wrist, turning the palm up and then turning it back, along with making sure all of your fingers have proper mobility as well. Strength exercises will be prescribed to improve your grip strength, your ability to exert force when twisting the wrist, grabbing items, and bearing weight through the wrist. Additional exercises will be prescribed for you to be able to perform your activities of daily living with no pain.
Through mobility and strength exercises given by your physiotherapist you should be able to return to sport and return to normal activity.
If you have any questions regarding your wrist pain, please give us a call at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.
Reference
Lubiatowski, P. Romanowski, L. Splawski, R. Manikowski, W. 2006. Treatment of injury of the Triangular Fibrocartilage Complex TFCC. Ortop Traumatol Rehabil. 30:8(3). 256-62.