Understanding the Causes and Treatments of TFCC Tears

Understanding the Causes and Treatments of TFCC Tears | WristWidget®

What is a TFCC?

The triangular fibrocartilage complex (TFCC), often called the wrist meniscus, stabilizes and cushions the wrist.

  • Components:
    • Cartilage cushion atop the ulna.
    • Radioulnar ligaments for bone stability.
    • Ulnar collateral ligaments (ulnotriquetral, ulnolunate).
    • Extensor carpi ulnaris tendon sheath.
Diagram of TFCC components in the wrist
TFCC Functions

The TFCC is the wrist’s main stabilizer.

  • Functions:
    • Supports grip, rotation, weight-bearing.
    • Stabilizes radius and ulna (distal radioulnar joint).
  • Load Distribution:
    • Radius: 80% of axial load
    • Ulna: 20% of axial load

Note: Colored sections in the animation represent TFCC components.

What causes a TFCC tear?

TFCC tears result from wrist injuries or stress.

  • Common Causes:
    • Rotational stress (e.g., drill use).
    • Heavy weight-bearing (e.g., gymnastics).
    • Falls on outstretched hand.
    • Direct wrist trauma.
  • Risk Factors:
    • Age:
      • 50% of 65+ have tears.
      • 27% of ≤30 with wrist injuries.
    • Chronic Inflammation:
      • 38.9% of severe rheumatoid arthritis cases.
  • Associated Effects:
    • Pain, tenderness, swelling.
    • Weak grip, instability.
    • Clicking/popping sounds.
What are the symptoms of a TFCC tear?
  • Key Symptoms:
    • Ulnar-side wrist pain.
    • Pain with gripping/rotation (e.g., doorknob).
    • Clicking or snapping sounds.
    • Pain during weight-bearing.
    • Wrist instability.

Notes: Swelling is rare unless fractures occur.

How is a TFCC tear diagnosed?

Diagnosis uses history, exams, and tests.

  • Diagnostic Process:
    • Medical history: Injury details.
    • Physical exam: Pain/instability tests.
    • Weight Bearing Test:
      • Uses non-digital scale to measure wrist strength.
      • Compare to unaffected wrist; reduced capacity suggests TFCC tear.
      • Most accurate non-invasive test.
      • Disclaimer: Confirm with a physician.
    • Imaging:
      • MRI: Useful but not always accurate.
      • X-ray: Rules out fractures.

Recommendation: See a hand specialist (1-3 week wait).

Non-Surgical Healing

Many TFCC tears heal without surgery using protocols like WristWidget®.

  • Healing Timeline:
    • Mild tears: 6-12 weeks.
    • Severe tears: Longer but often non-surgical.

Explore non-surgical recovery with WristWidget®.

How are TFCC tears treated?

Non-surgical options are first-line treatments.

  • Common Treatments:
    • Splinting (e.g., WristWidget® or casts).
    • Rest/activity modification.
    • Anti-inflammatory drugs.
    • Corticosteroid injections.
    • Physical therapy.
    • Ice/heat therapy.
  • Surgical Options:
    • For severe, non-responsive tears.
    • Note: Longer recovery (3-6 months), variable outcomes.
The WristWidget® TFCC Protocol

Wendy Medeiros, OTR, CHT, developed this approach after noticing rising TFCC injuries since 2000.

  • Background:
    • Lack of easy, accurate TFCC tests inspired an objective solution.
  • Weight Bearing Test:
    • Uses an inexpensive non-digital scale.
    • Measures wrist’s ability to press on the scale.
    • Most accurate way to assess TFCC damage.
  • Treatment Insight:
    • Surgery often has poor outcomes and long recovery.
    • Hard braces make tasks painful.
    • TFCC tears can heal without surgery if protocol is followed.
  • Expertise:
    • Wendy’s 25+ years as an Occupational Therapist and Certified Hand Therapist.

Watch Weight Bearing Test tutorial.

FAQs
  • What is a TFCC tear? Damage to wrist’s cartilage/ligaments, causing pain and instability.
  • Can it heal without surgery? Yes, often in 6-12 weeks with WristWidget® or other methods.
  • How does the Weight Bearing Test work? Measures wrist strength on a scale; lower capacity indicates TFCC tear.
  • What are symptoms? Ulnar-side pain, worse with gripping/rotation, clicking, instability.
  • How long is recovery? Mild tears: 6-12 weeks; severe: longer. Surgery: 3-6 months.
  • Can I exercise? Low-impact with splints may be OK; avoid high-stress moves.
  • How to prevent TFCC tears? Strengthen wrists, use proper techniques, wear braces.

Ask a question or submit your case.

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