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Triangular fibrocartilage complex (TFCC)

Triangular Fibrocartilage complex (TFCC) is a structure composed of cartilage and ligaments. It connects the forearm to the side of the wrist closest to the little finger, called the ulnar side.

Function:
1.  Stabilizer of the ulnar aspect of the wrist.
2. During weight bearing on the wrist or gripping activities, 20% of the load is transferred to the Ulna by the way of TFCC.

Types of injury:
1. Trauma (acute) .
2. Over-use (chronic degenerative).

Examples of type 1 (trauma):

1. Fall on hand & wrist .2. Twisting injuries of the wrist.3. About 39-84% of Distal end of radius fracture causes TFCC injury.

Examples of type 2 (chronic degenerative):

Repetitive movement that requires forceful twisting or pulling movements.
As I mentioned before, there are two types of TFCC injuries.
Each type can be further classified according to location and degree of injury.
This classification will help in designing the treatment plan.

Symptoms:

1. Ulnar-sided pain.2. Loss of grip strength.3. Clicking while moving the wrist & forearm.4. Limited wrist range of motion.

Diagnosis:

1. Clinical tests.
2. MRI: which is usually done after clinical tests to confirm the diagnosis and get more details about the injury (location & extent of injury) .
3. X-ray: to check if there is +ve variance of the ulna .

Treatment:

The treatment plan depends on the location and the degree of the injury.
First , physical therapy, I already talked about the program in a previous post. Please do not start the rehabilitation program without consulting a physical therapist first.

Each patient has his/her own treatment program and if you do the exercises without consultation, your condition may get worse.

PRP injection

PRP injection is also one of the treatment options of TFCC. Depending on the extent of the injury, hand surgeon will decide if you need it or not .

Surgery

I've talked about the classifications of TFCC injury and how each type has its own classifications.These classifications will help in determining the type of surgery that will be done

Physical therapy

Physical therapy postoperative is important to rehabilitate you backto your normal activitiesgradually. Skipping physiotherapy may affect your function and your recovery.The treatment plan depends on the location and the degree of your injury

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