Triangular fibrocartilage complex (TFCC) tear
What is it?
The triangular fibrocartilage complex (TFCC) is a strong gristle like disc that links the forearm bones together at the level of the wrist. It’s a complex structure that contributes to joint stability, as well as providing an articulating surface for the wrist and forearm bones. TFCC tears are usually the result of a fall on an outstretched hand. They are one of several types of so-called ‘wrist sprains’. These tears make wrist movements painful and cause loss of forearm rotational movement.
What is it?
How is it diagnosed?
TFCC tears are diagnosed on the basis of the history described above and by clinical examination for tenderness over the fibrocartilage plate itself. Provocation tests can be positive, for example the ulnar carpal abutment test. The diagnosis can usually be confirmed with an MRI scan. If the scan is negative, a wrist arthroscopy is sometimes required to confirm the tear.
What is my approach to treatment?
Most tears of the triangular fibrocartilage complex are minor and settle over time, although this can take as long as 12 months. Simple analgesics and steroid or occasionally stem cell injections can be useful during this period. Persistent, troublesome or severe tears require surgical treatment. This is normally carried out using wrist arthroscopy.
What does an operation involve?
It may be possible to shave down the TFCC tear to a stable margin, in which case recovery tends to be quick and near normal function can be expected within weeks. If the TFCC tear needs to be reattached with sutures (peripheral tears) then cast and or splint immobilisation may be required for up to eight weeks. Reasonable function is normally achieved within 3 to 4 months. See wrist arthroscopy for further details.
What is the recovery period?
3-4 weeks for debridement (shaving).
3-4 months for repair.
See wrist arthroscopy for further details.
Are there any possible complications?
Over 90% of patients are satisfied with the result. However, as with any treatment, there are always risks involved: Infection: Less than 1%, Tendon injury: Less than 1%, Chronic regional pain syndrome: 2%, Sinus discharge: 1%
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