Triangular Fibrocartilage Complex (TFCC) Injuries

What is a triangular fibrocartilage complex (TFCC) injury?

A triangular fibrocartilage complex (TFCC) injury is a tear of ligaments or cartilage in the wrist.

The triangular fibrocartilage complex (TFCC) is a small piece of cartilage and ligaments on the side of the wrist opposite your thumb. The cartilage is a tough rubbery tissue that acts as a cushion for joints. Ligaments are strong bands of tissue that attach the cartilage to bones. The TFCC is shaped like a triangle and makes it possible for the wrist to bend, straighten, twist, and move side to side.

What is the cause?

The ligaments or cartilage in the wrist can be torn if you injure your wrist. TFCC injuries are usually caused by:

• a fall onto an outstretched hand
• a direct blow to the side of the wrist or hand
• swinging a bat or a racquet
• a violent twist of the wrist

What are the symptoms?

Symptoms may include:

• pain on the side of the wrist opposite the thumb (the little-finger side)
• clicking sound or feeling, or a catching feeling when you move your wrist

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine your wrist and hand. Tests you may have include:

• X-ray
• magnetic resonance imaging (MRI), which uses a powerful magnetic field and radio waves to take pictures from different angles to show thin cross sections of the body
• arthroscopy, which uses a thin, flexible tube with a tiny camera to look inside joints

An MRI may be done as an arthrogram. This means that the MRI scan is done after a special dye is injected into the wrist to outline the cartilage and ligaments.

How is it treated?

Your provider will give you a splint or a cast to protect the wrist.

To reduce swelling and pain in the first day or two, your provider will probably tell you to:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth, on the injured area every 3 to 4 hours for up to 20 minutes at a time.
• Keep your hand up on a pillow when you sit or lie down.
• Take an anti-inflammatory medicine, such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.

Your provider may inject your wrist with a steroid shot to reduce inflammation and pain. A complete tear may need to be repaired with surgery.

It often takes 8 to 12 weeks for a TFCC injury to heal. Many tears become painless with rest and time even if they don't actually heal.

How can I take care of myself?

• Follow your treatment plan.
• Follow your provider’s instructions for doing exercises to help you recover.
• Keep all appointments for provider visits or tests.
• Contact your healthcare provider if you have new or worsening symptoms.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your wrist recovers, not by how many days or weeks it has been since it was injured. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal is to return to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may return to your normal activities when:

• Your injured wrist has full range of motion without pain.
• Your injured wrist, hand, and forearm are as strong as the uninjured side.

How can I help prevent a TFCC injury?

Many injuries are caused by falls or blows that can be hard to prevent. If you play a racquet sport, like tennis, using good technique can help prevent injury.