Wrist pain – TFCC injuries

The triangular fibrocartilage complex is located on the ulnar side of the wrist (ie. pinky finger side). It contains a central disc and supporting structures called the radioulnar ligament (RUL) and ulnocarpal ligaments (UCL). The two main purposes of the TFCC is for load transmission and rotation support. The central disc allows for a greater coverage of the ulna from the distal radius. The RUL and UCL will tighten or loosen depending on the rotation or pronation/supination in the wrist.

The main causes of injury to the TFCC can be divided into degenerative or traumatic cases. Traumatic injuries may involve include falling, weightbearing, twisting, and traction. You may have pain with movements such as turning a key, pushing from getting up from a chair, pushups, bending your wrist backwards, pulling, or holding plates. Certain sports also tend to have a higher risk of TFCC injuries such as tennis and gymnastics.

Many TFCC injuries can be managed non-surgically. Surgery is normally reserved only if conservative management has been unsatisfactory or if the initial injury is severe. In most cases, conservative management will require immobilisation for a period which can be up to 6 weeks. This is an important stage to allow the structures to heal without irritation or provocation and then to progress onto progressive movement and exercises.



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