What is a triangular fibrocartilage complex injury of the wrist?

An injury to the TFCC or triangular fibrocartilage disc is an injury to the part of your wrist at the end of the ulna, which is this bone running up from your elbow to your wrist.

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Gordon Bohlmann, BSc.PT, IMS, Physiotherapist, discusses what is a triangular fibrocartilage complex injury of the wrist (TFCC)

Quiz: Do You Understand Wrist Sprains?

Test your knowledge by answering the following questions:

Questions
True
False
1

There are three grades of wrist sprain, with 1 being the most severe and 3 being mild.

Explanation:
There are three grades of wrist sprain, with 1 being mild and 3 being the most severe.
2

Wrist sprains can even pull off a tiny piece of bone.

Explanation:
There are many ligaments in the wrist that can be sprained. Wrist sprains can even pull off a tiny piece of bone (called an avulsion fracture).
3

A feeling of popping can be a symptoms of a wrist sprain.

Explanation:
Symptoms of a wrist sprain include pain, swelling, bruising and a feeling of warmth, popping or tearing.
4

A mild wrist sprain probably requires prescription pain medication.

Explanation:
A mild wrist sprain will generally improve with the RICE protocol (rest, ice, compression and elevation) and anti-inflammatories. A more serious wrist sprain may need a splint to completely heal.
5

A severe wrist sprain my require surgery to fully repair the torn ligament.

Explanation:
A severe wrist sprain my require surgery to fully repair the torn ligament. The orthopedic surgeon will reconnect the torn ligament to the bone or perform a tendon graft.
(Answer all questions to activate)

What is a triangular fibrocartilage complex injury of the wrist?

An injury to the TFCC or triangular fibrocartilage disc is an injury to the part of your wrist at the end of the ulna, which is this bone running up from your elbow to your wrist.

The disc is a very strong ligament and cartilage type structure that sits between your ulna and your wrist bones. The function of this disc is to stabilize this joint and allow it to rotate and move freely.

Your physiotherapist would ask you about the mechanism of injury.  For example, did you fall on an outstretched arm or was it an injury that occurred while you were using a power tool such as a drill where the drill bit got stuck and the drill torqued your arm and caused a big rotation.

So the mechanism of injury is important. Secondly, there are some orthopedic tests that your physiotherapist will do, such as the piano key test or the distal radial ulna joint stress test and that will give your physiotherapist information about whether or not your TFCC complex was disrupted or torn.

Once your physiotherapist has determined whether or not there are any other aspects that could be involved such as a tendonitis of one of the extensors of your forearm. The TFCC would mostly be treated conservatively first, which probably involves a period of time where it’s braced or immobilized.

That would be a period of time to allow scarring to occur and for that ligament complex to heal. Secondly, you’d be looking at some strengthening exercises to try to increase the strength of the adjacent muscles and tendons.

And if after all of those efforts have failed then your physiotherapist would be the one who would refer you to the appropriate practitioner to deal with it in a non-conservative way if you’d fail a conservative therapy.

In terms of the whole team of care you would be looking at a physiotherapist, potentially a specialist in bracing, such as a hand therapist, which is a specialized physiotherapist or occupational therapist, and eventually if things are not healing well you’d potentially need a consult with an orthopedic surgeon to determine whether that was the correct treatment form for you.

If you have any questions, if you think that this may be an injury that you have please see your physiotherapist or a general practitioner today. Local Orthopedic Surgeon.

Presenter: Gordon Bohlmann, Physiotherapist, Vancouver, BC

Local Practitioners: Physiotherapist

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