The Triangular Fibrocartilage Complex (TFCC) is a vital structure in the wrist (on the little finger side), consisting of ligaments, tendons, and the triangular fibrocartilage disc. It plays a crucial role in stabilising the wrist joint and facilitating smooth movement during activities. TFCC injuries, often from falls or repetitive stress, involve damage to these structures, ranging from minor sprains to complete tears. Degenerative changes can also occur, leading to chronic pain. Understanding TFCC injuries is crucial for diagnosis and treatment.
TFCC injuries manifest with various signs and symptoms, indicating damage to the wrist structures. These may include:
- Wrist pain, particularly on the pinky side, often exacerbated by gripping or rotating activities
- Swelling and tenderness in the wrist area, especially near the base of the pinky finger
- Clicking or popping sensations during wrist movement
- Weakness and limited range of motion, impairing daily activities and functional tasks
- Painful catching or locking of the wrist, particularly during movements that stress the TFCC
Accurate assessment of TFCC injuries is crucial for effective management and prevention of long-term complications. Assessment methods may include:
- Comprehensive physical examination to evaluate wrist stability and function, assessing for tenderness, swelling, and range of motion
- Specialised tests to assess TFCC integrity to identify specific areas of pathology
- Diagnostic imaging for confirmation of diagnosis and assessment of injury severity, including the presence of fractures, ligament tears, or cartilage damage
- Further referral if needed for consideration for advanced treatment options
TFCC injuries can mimic or co-exist with other wrist conditions, necessitating differential diagnosis to guide treatment. These may include:
- Ligament sprains, such as injuries to the scapholunate ligament or lunotriquetral ligament
- Tendonitis/tendinopathy, involving wrist tendons, particularly the extensor carpi ulnaris tendon
- Arthritis, including osteoarthritis or inflammatory arthritis affecting the wrist joint
- Wrist fractures, such as distal radius fractures or ulnar styloid fractures, which may present with similar symptoms to TFCC injuries
Physiotherapy plays a main role in the management of TFCC injuries, offering various treatment modalities to promote healing and restore function. Treatment approaches may involve:
- Rest and immobilisation to allow for proper healing of the injured TFCC, often achieved through splinting or bracing. Some braces can be purchased from the local pharmacy, but others may need to be made from a local hand therapist.
- Therapeutic exercises targeting muscle strength and flexibility in the wrist and forearm, focusing on improving stability and reducing pain
- Manual therapy techniques such as mobilisation and soft tissue massage to reduce pain and improve joint mobility
- Functional training to improve wrist stability and coordination for a safe return to activities of daily living, including work and recreational activities
- Education and lifestyle modifications including education on proper biomechanics, injury prevention strategies, and activity modification to minimise the risk of reinjury and promote long-term joint health.
In summary, understanding TFCC injuries is essential for guiding assessment and treatment decisions. Early recognition and appropriate management of TFCC injuries can help prevent long-term complications and facilitate a quicker return to functional activities. If you suspect you've sustained a TFCC injury, booking an assessment with one of our experienced physiotherapists at The Optimal Health Lab can provide clarity on the extent of your injury and facilitate proactive steps towards assessment and treatment. Bookings available via 9431 5955 or you can book online via the Client Portal on our website.
