fb

Triangular Fibrocartilage Complex (TFCC)

by | Upper Body

The triangular fibrocartilage complex (TFCC) is a small, load-bearing, disc-shaped structure located on the pinky (baby/small finger) side of your wrist. A TFCC injury is the most common cause of wrist pain on the pinky side. It can either be sustained due to trauma by falling on an outstretched arm with a rotation of your wrist towards the thumb, or due to a chronic lesion from repetitive rotation of the wrist, commonly sustained in racquet sports.

The main symptoms in association with a TFCC injury

The main symptoms of this condition include the following, but patients do not necessarily experience all of the symptoms:

  • Pinky-sided wrist pain and tenderness
  • Pain with gripping and wrist rotation against resistance
  • Reduced wrist range of motion
  • Pain with weight-bearing on the wrist
  • Clicking with wrist rotation
  • Sensation of wrist instability

Diagnosis of this injury is based on many factors and assessments. There is no single test or symptom that can confirm the diagnosis.

How can physiotherapy help?

Physiotherapy is usually the first line of treatment prescribed for TFCC injuries and has been proven to be very effective in resolving the symptoms. Only after a thorough rehabilitation programme is completed and the symptoms persist, may surgery possibly be indicated.

The initial phase would require a short period of immobilisation. Thereafter, the goals of physiotherapy include improving the range and strength of all the muscles supporting the TFCC. This will be achieved through various hands-on techniques and a comprehensive rehabilitation programme. If needed, physiotherapy can be combined with anti-inflammatory medication to manage pain.

References
  1. Lerma, E.G. et al. (2022) ‘Rehabilitation in Triangular Fibrocartilage Complex Injuries: Treatment Algorithm’, Revista Iberoamericana de Cirugía de la Mano, 50(01), pp. e49–e59. Available at: https://doi.org/10.1055/s-0042-1748854.
  2. Pace, V. et al. (2024) ‘Review and update on the management of triangular fibrocartilage complex injuries in professional athletes’, World Journal of Orthopedics, 15(2), pp. 110–117. doi:10.5312/wjo.v15.i2.110.
  3. Rios-Russo, J.L. et al. (2021) ‘Ulnar-sided wrist pain in the athlete: Sport-specific demands, clinical presentation, and Management Options’, Current Sports Medicine Reports, 20(6), pp. 312–318. doi:10.1249/jsr.0000000000000853.
  4. Sander, A.L. et al. (2020) ‘Outcome of conservative treatment for triangular fibrocartilage complex lesions with stable distal radioulnar joint’, European Journal of Trauma and Emergency Surgery [Preprint]. Available at: https://doi.org/10.1007/s00068-020-01315-2.
  5. van der Post, A. et al. (2022a) ‘The triangular fibrocartilage complex in the human wrist: A scoping review toward uniform and clinically relevant terminology’, Clinical Anatomy, 35(5), pp. 626–648. doi:10.1002/ca.23880.