You can find a structure of cartilage in your wrist known as triangular fibrocartilage complex (TFCC). The cartilage runs along the side of your wrist on the same side as your pinky finger. It provides cushioning support to the carpals, which are a collection of eight small bones in your wrist.
In addition to supporting the carpals, the TFCC also stabilizes your radius and ulna (bones found in the forearm) when you grip an item or rotate your forearm. Unfortunately, a TFCC tear can cause pain and a wide range of debilitating issues. Understanding the causes, symptoms of the tear can help.
Common Causes of a TFCC Injury
Although you can suffer a torn ligament in wrist areas from simple accidents and activities, sports are usually your most common source of injury. If you are running across the field and happen to fall palm down with your arm outstretched, it can put excessive force on your wrist. Unfortunately, if the fall hyperextends your wrist, it could tear the ligament.
While a fall is one cause of this type of injury, there are other ways you can tear the TFCC. For instance, improper rotation of the wrist, or rotating the wrist while experiencing an impact can also lead to injury. Athletes who experience an increased risk of TFCC tears include golfers, gymnasts, tennis, hockey, and baseball players.
TFCC Injury Explained
It is important to know that two types of tears can occur in your TFCC. The first is a traumatic tear, which occurs because of an injury. It is the first type of tear that more commonly occurs among athletes.
The second is a degenerative or chronic tear. Degenerative or chronic TFCC tears occur when the cartilage wears down as you age. A person who has rheumatoid arthritis or other inflammatory diseases is more likely to suffer a degenerative or chronic tear.
Bear in mind that injuries to the TFCC caused by impact may also result in fractures to the ulna or radius. In fact, fractures of these two forearm bones occur in approximately 50% of accidents that cause TFCC tears. Make sure you pay attention to any pain that may occur in your forearm after suffering a wrist injury.
Symptoms of a Tear
If you have a TFCC tear injury, you will experience very noticeable symptoms. Symptoms may include:
- Swelling of the wrist
- Pain and a “clicking” sound when attempting to move the wrist
- Inability to grip items because of a lack of strength and/or intense pain
- Pain that worsens when bending the wrist side-to-side
- Pain that occurs at the base of the pinky and radiates down the side of the wrist
It is important to note that as an athlete, you should always have a doctor assess you after you suffer a hard fall or potential injury. However, some athletes experience such an adrenaline rush that they do not feel the pain of their injuries until later.
If you suffered a fall or any impact to your wrist and you experience any of the symptoms above, it is likely that you have a tear in your TFCC. It is important that you have a medical professional evaluate your wrist to determine if a tear is the cause of your symptoms.
TFCC Tear Diagnosis
Medical professionals have specific measures they can use to diagnose tears to your cartilage and ligaments. A physical examination takes place first. The doctor will test the range of motion in your wrist using minor manipulation.
Manipulation allows the doctor to determine the extent of your pain, where the pain radiates from, and how much mobility your wrist has. If the doctor suspects you have a tear to the TFCC, he or she may order an X-ray.
The X-ray will show if you have any fractures in your wrist or the bones of your forearm. The doctor will also likely order an MRI. An MRI is the most reliable form of imaging because it allows doctors to assess damages to the cartilage and tissues.
If the doctor confirms a tear to your TFCC, you will likely need to make an appointment with a specialized physician who deals with traumatic injuries to the wrist. A specialist can provide you with the proper methods of treatment based on the extent of your injury.
TFCC Injury Treatment Options
Injuries to your TFCC may range from mild to severe. For that reason, the treatment options given to you will vary. For minor TFCC injuries or tears, your doctor will offer non-surgical options. Nonsurgical options can include:
- A splint or cast to help stabilize your wrist while healing
- Medications to reduce inflammation, including OTC medications like ibuprofen
- Cortisone injections into the wrist to help reduce inflammation and promote healing
- Ultrasound therapy, which uses low-intensity ultrasound pulses to repair damaged cartilage
Sometimes a mild to moderate injury does not respond well to non-surgical treatments. In these instances and instances of a moderate to severe TFCC tear, you are likely to need surgery. Surgical treatment will “clean” the damaged cartilage by tidying up the torn edges of the cartilage, or it will repair the tear entirely.
Sometimes a person will experience a TFCC injury because of a condition referred to as Ulnar Impaction Syndrome. It is a degenerative condition that causes the head of the ulnar to push into the carpals and TFCC. Your doctor will recommend surgery to treat the condition and repair TFCC injuries by cutting the bone down to the proper length to avoid further injury.
Depending on the surgical method your doctor uses, recovery can range from just a few weeks to several weeks. You may even need physical therapy after surgery to restore your wrist back to proper functioning form.
TFCC At Home Treatment Options
Although you must see a medical professional for proper treatment of your TFCC injury, there are also steps you can take at home to reduce pain, swelling, and discomfort. Although you will likely need to take an anti-inflammatory medication, you can also apply ice to the affected area. Ice can reduce pain and swelling.
Make sure you also rest your hand and wrist as much as possible. A brace or splint can help support your wrist and minimize movement to facilitate healing and prevent further damage. Opt for a brace or splint that allows you to move your fingers with ease so you can still perform certain daily tasks.
However, you should avoid certain activities that require you to bend or strain your wrist further. For instance, you should avoid any heavy lifting. If you are an athlete, you will need to take a break from training and practice until your doctor gives you the all clear.
If you do not rest your hand and wrist as necessary, you can injure your TFCC further. When taking anti-inflammatory medications, you will need to do your best to pay attention to your doses at home. For instance, if your doctor prescribed you with something, make sure you do not double up between your prescribed medication and OTC medications.
You can take ibuprofen every 6-8 hours, aspirin every 4-6 hours, and naproxen every 12 hours. Therefore, if you take ibuprofen to relieve swelling, you would have to wait approximately 8 hours before using naproxen. If you use naproxen, you would have to wait 12 hours before taking ibuprofen.
Write down the time you take medication to keep track, so you do not accidentally double up on anti-inflammatories. Make sure you also keep track of OTC medications you use so you can let your doctor know. Some OTC medications may have a negative interaction with prescribed medications.
What to Expect After Surgery
If your TFCC tear requires injury, there are some things you should know. For starters, most patients return home the same day of their surgery. In most situations, wrist surgery does not require an overnight stay.
While at home, make sure you wear your splint as instructed. Do not take it off, even to shower. Place a protective cover over the splint, so it stays clean and dry when you take a shower. You should avoid lifting, pushing, and pulling at all costs or you run the risk of re-injury.
The incisions involved with your surgery are usually small. However, swelling can still occur after surgery. To minimize swelling, use anti-inflammatory medications either prescribed to you or purchased over the counter. Make sure you also elevate your hand so that it is above the level of your heart.
Another suggestion is to flex your fingers. Open them to a full extension and close them back again. You do not have to squeeze your hand into a tight fist. Fluid can build up around the surgical area, and flexing your fingers releases that fluid so that it moves back through your hand and toward your heart.
Most importantly, if you have any questions, you should contact your physician. Your physician can help you address concerns with pain, inflammation, questions involving your incisions, and any other discomfort you might feel after TFCC repair surgery.
Make sure to keep your physician’s phone number handy. If possible, request an emergency number so you can contact your physician after hours as needed.