The wrist is a complex area of the body, made up of numerous bones, tendons and ligaments. An important structure within the wrist is the triangular fibrocartilage complex (TFCC). It is located on the little finger side (ulnar side) of the wrist and is made up of tough fibrous tissue and cartilage that act together to support and stabilise the wrist. It helps hold the lunate, triquetrum and ulna bones together and acts as a shock absorber. When injured, the wrist may feel sore, unstable and may lack strength.
Definition
TCFF injuries are tears in the cartilage type structure located on the ulnar side of the wrist. These tears can be partial or full thickness and may even involve the attachment points on the bones (avulsion injury). A partial TFCC injury involves only part of the soft tissue and is considered more stable than a full-thickness tear. A full-thickness tear involves more of the soft tissue, while an avulsion injury has separated the TFCC from one of its bony attachment points.
Causes
TFCC injuries are classified into two groups based on the mechanism of injury: traumatic or degenerative.
Traumatic TFCC injuries are caused by an incident or trauma to the wrist for example, a fall onto the hand, or a sudden twist of the arm that over rotates the wrist.
Degenerative TFCC injuries are caused by wear and tear over time. Repetitive movements such as using tools can break down the tissue of the TFCC resulting in this injury.
Signs & Symptoms
TFCC injuries may present with the following symptoms:
- Pain in the ulnar side of the wrist
- Pain with weight-bearing and twisting movements
- Clicking on the wrist
- Loss of grip strength
A thorough clinical examination is required to diagnose a TFCC injury. In some cases, an MRI is used to gain extra information about the type and severity of the injury.
Treatment
Many TFCC injuries can be treated conservatively. The severity, type or location of the tear will dictate if surgery is required (e.g., with avulsion injuries). In most cases, surgery is not required.
Wrist splints or supports called wrist widgets are often prescribed to help with pain control and stabilising the wrist. Once the TFCC is deemed ready, an exercise program is commenced. Gentle movement and use of the limb are encouraged. Proprioceptive exercises are incorporated into the program as soon as possible. These exercises specifically target the mechoreceptors within the wrist and involve multidirectional movements/ stability or controlling the wrist with perturbations.
Melbourne Hand Therapy Can Help You
At Melbourne Hand Therapy, our team works closely with your medical team and is able to assist you with splinting and rehabilitation. Our treatment is tailored to your individual needs and is dependent on the type of injury, age of injury, presentation, and severity. Book in an appointment today to see one of our highly skilled therapists if you are experiencing any of the symptoms above.
