What is a Triangular Fibrocartilage Complex Tear?

A triangular fibrocartilage complex tear, or TFCC, is a tear of the cartilage that connects and supports the carpal bones in your wrist and the bones in your forearm. If the cartilage tears, then you will likely feel pain.

Types of TFCC

There are two types of triangular fibrocartilage complex tears:

• Type 1—The first type of TFCC tear is considered a traumatic tear. Traumatic tears occur when you experience a strike to your wrist, fall on your extended hand, or rotate your wrist too much. Athletes who regularly rotate or apply pressure to their wrists are at higher risk for this type of tear.
• Type 2—The second type of TFCC is a degenerative tear. Degenerative tears are associated with age. As our cartilage weakens over time, even minimal injuries or trauma can cause a tear.

Signs & Symptoms

You may experience common signs and symptoms of a TFCC injury or TFCC tear.

Common triangular fibrocartilage complex injury symptoms:

• Wrist pain—You will likely feel pain at the base of your wrist.
• Swelling—Your wrist might also feel and look swollen.
• Reduced grip strength—You may feel weaker in your wrist, and notice decreased grip strength.
• Limited movement—Individuals with a wrist triangular fibrocartilage complex tear experience a reduced range of motion in their hand and wrist.
• Clicking—When you move your wrist, you may hear a clicking or popping sound.
• Tenderness—Your wrist may also feel sore and tender.

Causes

Triangular fibrocartilage complex tears are caused by injury, age, preexisting conditions, and repetitive wrist rotation.

TFCC causes:

• Repetitive Motions—Excessive rotation of your wrist can lead to triangular fibrocartilage tears.
• Direct Injury—Direct trauma to your hand or wrist can cause a TFCC tear.
• Falling Injury—If you fall on your outstretched hand, you can injure your TFCC.
• Age—The older you get, the more your bones and cartilage weaken. This makes you more vulnerable to TFCC injuries.
• Pre-existing Conditions—Certain congenital conditions such as ulna variance can put you at higher risk for TFCC.

Diagnosis

Your doctor will diagnose a TFCC tear by a general exam, discussion of your medical and family history, and conducting a triangular fibrocartilage complex test.

TFCC tests include magnetic resonance imaging (MRI) and X-Ray.

MRI

Your doctor will use magnetic resonance imaging (MRI) to look at your wrist. MRI provides detailed images of the bones and tissues in your body. By looking at these images, your doctor can tell if you have a TFCC tear.

X-Ray

Your doctor may also use an X-Ray to examine your wrist and forearm bones. X-Rays send a low-level of radiation through your body onto an image plate. The plate is then developed to reveal the bones and show any injuries or disease. If there is a TFCC tear, it will appear as a fracture or opening in one of the bones.

Treatment

The three main treatments for triangular fibrocartilage complex pain are medications, therapy, and surgery. Mild tears often respond to nonsurgical options. Severe tears might require surgical treatment.

Triangular fibrocartilage complex treatments:

• Medication—Anti-inflammatory medication reduces inflammation and swelling. Corticosteroid injections also help reduce swelling.
• Therapy—A physical therapist will help you learn to safely use your wrist and hand. You may also temporarily wear a splint to immobilize your wrist. Usually, you will wear a splint or a cast for up to 4-6 weeks.
• Minimally Invasive Surgery—Arthroscopy is a popular triangular fibrocartilage complex surgery. During this minimally invasive procedure, your doctor inserts a small camera through tiny incisions in your wrist to see the triangular fibrocartilage complex. Once he or she can see the tear, the doctor will clean the area and correct the tear.
• Open Surgery—If your injury is more severe, open surgery may be necessary for triangular fibrocartilage complex repair. Open surgery involves larger incisions and making repairs to the ligaments and tendons around your wrist. These repairs often involve fixation devices like metal screws and pins.

After surgery, your doctor may prescribe medication, physical therapy, and a period of rest from your regular activities, such as driving, working, exercising, sports, and other extracurricular hobbies.