Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Triangular Fibrocartilage Complex Tears

The triangular fibrocartilage (TFC) is a cartilaginous disk, much like the meniscus cartilage of the knee, which overlies the distal aspect of the ulna in the wrist joint. It is part of the TFC complex (TFCC) which supports the carpal bones on the ulnar side of the wrist and provides some stability for the distal radioulnar joint (part of the wrist). Tears of the TFCC can occur from trauma, overuse, or tissue degeneration. Tears are often associated with a long ulna in relation to the radius at the wrist joint (positive ulnar variance). The traumatic tears are caused by injuries with impaction, rotation, and ulnar deviation.

Symptoms and diagnosis

– Symptoms are often vague.
– Ulnar-sided wrist pain is felt.
– Pain is elicited when testing with compression, ulnar deviation, and circumduction. A painful click or clunk may be felt during this maneuver and on anterior-position movement of the ulna.
– An MR arthrogram of the joint and arthroscopy will secure the diagnosis.

Treatment

The doctor may:
– immobilize the wrist for 4–6 weeks;
– operate if symptoms persist after immobilization and a rehabilitation program. Surgical options include repair or excision of tissue. The arthroscope has been useful in the diagnosis and treatment of TFCC
injuries. Return to sports such as tennis may be possible in 3–4 months.

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