Distal Radio Ulnar Joint & TFCC injuries

The triangular fibrocartilage complex (TFCC) connects the bones in your forearm with bones in your wrist. The structure — made up of ligaments, tendons and cartilage — helps support and stabilize your wrist. You can tear your TFCC if you fall on, twist or fracture your wrist. TFCC tears can also result from tissue wearing down as you age.

What is a TFCC tear?

The triangular fibrocartilage complex (TFCC) helps stabilize your wrist. Your TFCC consists of ligaments and cartilage. It attaches your forearm bones (ulna and radius) to each other and to the small bones of your wrist. Your TFCC helps stabilize, support and cushion your wrist.

You can rotate your wrist and grip objects tightly thanks to your TFCC. When you tear your TFCC, your wrist joint may feel weaker and less stable.

How common are TFCC tears?

This small but complex structure can tear easily as a result of a sudden impact or twisting injury. TFCC tears also happen more often in older adults, as the tissues that make up your TFCC break down and become thinner with age. This degeneration leaves your TFCC more vulnerable to tears.

What causes a TFCC tear?

There are two main causes of TFCC tears:

Injury: The force of falling on your hand or wrist can tear your TFCC. A fall or other injury that fractures your radius can also tear your TFCC. A sudden twist of your arm that over-rotates your wrist can also cause a TFCC tear.
Degeneration: Like all tendons and ligaments in your body, your TFCC wears down and gets thinner with age. Thinner tissues are more likely to tear. These chronic TFCC tears often occur gradually over time. Repetitive motions (such as swinging a bat or racket) can also break down tissues that make up the TFCC, leading to tears.

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What are the symptoms of a TFCC tear?

In many cases, chronic or degenerative TFCC tears don’t cause pain or other symptoms. If you tear your TFCC as the result of an acute injury, you may have symptoms such as:

Sounds, like clicks or pops, when you rotate your wrist or forearm.
Difficulty rotating your wrist.
Pain on the ulnar side of your wrist (outside, near the pinky finger).
Reduced ability to grip objects tightly.
Wrist weakness.

What are the complications of a TFCC tear?

A minor TFCC tear may heal on its own. But leaving a severe TFCC tear untreated can lead to a weak or unstable wrist.

Diagnosis and Tests

How is a TFCC tear diagnosed?

Your healthcare provider will ask about your medical history and ask how and when your wrist pain started. They’ll also perform a physical exam. They’ll press on different areas of your wrist to assess your range of motion and strength.

Your provider may also recommend imaging tests — such as X-rays or MRI — to look for fractures or tears.

Management and Treatment

How is a TFCC tear treated?

Minor TFCC tears often heal without treatment. If you don’t have pain or weakness in your wrist, your provider may recommend letting the tear heal on its own.

Some TFCC tears cause symptoms and interfere with your ability to perform daily activities. In these cases, your provider may recommend treatment. Options include:

Medication: Anti-inflammatory medications (such as NSAIDs) can help reduce swelling and relieve pain.
Bracing: Keeping your forearm and wrist stable with a brace or splint can allow your TFCC to heal.
Injections: Cortisone shots help reduce the swelling of torn tissue.
Physical or occupational therapy: Exercises can strengthen the muscles in your wrist and forearm to prevent further injury.
Surgery: If more conservative treatments don’t provide relief, your provider may recommend surgery. In most cases, minimally invasive arthroscopic surgery can repair TFCC tears.

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Distal Radio Ulnar Joint & TFCC injuries