TFCC Tear and Ulnar‑Sided Wrist Pain

 

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What is it?

The triangular fibrocartilage complex (TFCC) is a group of ligaments and cartilage on the little‑finger side of the wrist that cushions load and stabilises the joint between the radius and ulna. Injury can occur after a fall, twisting injury, or through gradual wear in people with relative ulna over‑length.

 

Symptoms and progression

Patients commonly report pain when turning a key or screwdriver, pushing up from a chair, or lifting with the palm down. Clicking and weakness are common. Chronic tears may be associated with distal radioulnar joint instability and progressive cartilage wear.

 

Diagnosis

Examination focuses on pinpoint tenderness and stability testing. MRI is useful but imperfect; wrist arthroscopy remains the gold standard in uncertain cases.Non‑surgical treatmentInitial treatment includes activity modification, bracing, hand therapy and corticosteroid injection. Stable degenerative tears can often be managed without surgery.

 

Surgery – arthroscopic TFCC debridement or repair ± ulnar shortening

Surgery is recommended when pain persists despite structured conservative management or instability is present. Through keyhole portals the torn tissue is trimmed or repaired. If ulnar impaction contributes, the ulna may be shortened with plate fixation. Debridement allows earlier motion, whereas repairs require longer protection. Therapy continues for several months. Risks include stiffness, persistent pain, infection and nerve irritation.

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What does the rehabilitation/recovery involve?

To find out more about rehabilitation and recovery after surgery please see our Rehabilitation Protocols here.