Between your ulna and radius, the main bones in your forearm, there’s a small area called the triangular fibrocartilage complex (TFCC). The TFCC is made of cartilage, ligaments, and tendons. It links the forearm to the side of the wrist closest to the pinkie finger, called the ulnar side. The TFCC is susceptible to tearing, which can leave the wrist and pinkie useless.
The TFCC is load-bearing, meaning that it remains under stress and has to bear weight often. It stabilizes the wrist and allows your wrist to bend in six different directions. This is why it’s frequently used.
TFCC injuries can be acute or chronic. Acute injuries are one-time instances resulting from a specific instance. Chronic injuries are ongoing and happen because of wear and tear on the wrist.
TFCC tears happen when your wrist is twisted and the TFCC bears the weight. When you swing a racket, bat, or similar object, your wrist is in a prime position to tear your TFCC. In fact, many patients with chronic TFCC tear have a history of playing individual sports like baseball or tennis.
You can also tear your TFCC because of the following:
- Falling and landing on your hand or wrist
- Twisting your arm while catching something like a drill bit
- Fracturing the end of your radius bone
The chances of a TFCC tear increases as you get older. It’s not common in people under 30 years old, but it affects about half of those over 70 years old. If you have preexisting conditions like rheumatoid arthritis or gout, you're at high risk of a TFCC tear. You’re also more likely to tear your TFCC if your ulna bone is longer than your radius bone. Your TFCC is thinner here and can tear easily.
TFCC tears usually come along with ulnar-sided wrist pain. You’ll feel the following:
- Your grip is weaker than normal.
- Your wrist is unstable.
- Your wrist constantly clicks or pops as you move your hand.
- Your wrist has a limited range of movement.
If you think your TFCC is torn, see a healthcare provider immediately. Other TFCC conditions can have similar symptoms. But a professional can run tests to see if you have a TFCC tear or another TFCC injury. These examinations can include the following:
- Grabbing the bottom of a table or desk with your palms facing up. If it’s painful, your TFCC is probably torn.
- Letting your forearm relax to see if your fingers curve out toward your pinkie. Curving means you might have a TFCC injury, but not necessarily a tear.
- Pressing on the ulna bone. If it’s painful, you might have a TFCC tear.
- Getting off of a chair in a sitting position. If it’s painful, you could have a torn TFCC.
- Laying both hands flat on a table or desk and pressing the palms of your hands down. Your ulna bone may be visible when your hands are pressed but goes away when your hands are relaxed. This can be a sign that you probably have an injured, although not torn, TFCC.
- Extending your arms, applying pressure, and rotating your forearm. If it’s painful, your TFCC might be torn.
To help your healthcare provider give you an accurate diagnosis, give them as much detail as possible about your injury. Recall what happened when you first felt the symptoms, when they were the most intense, what helped relieve them, and so on.
If your test results are positive, your doctor will order an MRI to confirm the tear and uncover how serious it is. They might also order an X-ray to make sure that your bones aren’t fractured.
If a healthcare professional decides that you have a TFCC tear, there are a few ways you can help it heal. To relieve your pain, you can do the following:
- Apply ice on the TFCC.
- Wear a splint or a cast.
- Take a break from sports or other activities that strain your wrist.
- Take anti-inflammatory medicine or over-the-counter pain medicine.
- Do physical therapy as directed by your doctor.
- Take corticosteroid injections if your doctor recommends them.
If your TFCC tear is severe, you might have to undergo surgery. See a hand surgeon if you think you fall into this category.
Acute TFCC tears don’t have any long-term complications. If you take the proper steps to heal your injury, you can resume normal activities after a few months.
If you have a chronic TFCC tear, you’ll need to take continuous care of your wrist. The best thing you can do is avoid a lot of repeated wrist movements. You can also modify motions that are typically painful.