Mechanism of Injury For Triangular Fibrocartilage Complex Tears
Anyone can suffer a Triangular Fibrocartilage Complex Tear so factors associated with TFCC injuries and anatomical variations attributed to injury are listed below:
- They occur most commonly associated with falls on an outstretched hand in a situation where the individual falls, landing on the hand with the wrist backwards and the forearm rotated into pronation. Causing compression load on TFCC during marked ulnar deviation. As a result of this mechanism TFCC tears can occur associated with wrist fractures.
- Athletes who put a lot of pressure on the wrist, such as gymnasts, or those playing racquet or stick sports like tennis, baseball, hockey… are also at risk of developing a triangular fibrocartilage complex tear. Swinging a racquet or bat causes increased load on the TFCC through forced ulnar deviance.
- Positive ulna variance, where individuals have a longer ulna (forearm bone that is on the little finger side of the body) can contribute to this TFCC tears, because this anatomical variation puts more pressure on the TFCC.
- Degenerative tears of the triangular fibrocartilage complex, are more common in people over 50 years old more likely to suffer with these degenerative complaints if the individual was involved heavily in the above mentioned sports or had a number of previous episodes of falls in their younger years.
Diagnosing TFCC Tears
When looking clinically to diagnose the TFCC as a source of pain then careful attention needs to be paid to the mechanism of injury, looking for a history of involvement in sports as listed above or history of a fall. And as discussed above any history of ongoing symptoms such as ‘pain lifting yourself out of a chair, with wrists in extension’ often indicates a suspicion of a triangular fibrocartilage complex tear.
Examination of the wrist includes:
- Assessing the exact location of the pain, as well as any tenderness on palpation of structures.
- Special tests looking to reproduce pain and/or clicking or grinding sensations these typically look to move the wrist into ulna deviation positions reproducing compression on the TFCC area.
- Signs of functional limitation due to pain or weakness.
- X-ray’s may also be used, an X-ray can check for fractures and other abnormalities, including evaluating ulnar variance.
- An MRI is generally considered the most reliable non-invasive imaging test for diagnosing TFCC tears.
- Arthroscopy is sometimes employed as a diagnostic test for patients with ongoing functional limitation and persistent pain.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance on Triangular Fibrocartilage Complex Tears should consult his or her general practitioner, sports medicine specialist, orthopaedic surgeon or physiotherapist.