Triangular Fibrocartilage Complex Tears

Mechanism of Injury For Triangular Fibrocartilage Complex Tears

Anyone can suffer a Triangular Fibrocartilage Complex Tear. So, the factors associated with TFCC injuries and some of the anatomical variations attributed to injury are listed below:

• TFCC tears are most commonly associated with falls onto an outstretched hand. Situations where the individual falls, landing on the hand with the wrist backwards and the forearm rotated into pronation. This action causes compression load on TFCC during marked ulnar deviation. As a result of this injury mechanism, TFCC tears can be associated with wrist fractures.
• Athletes who put a lot of pressure on the wrist, including gymnasts, and racquet or stick sport athletes like tennis, baseball, and hockey players… are at risk of developing a triangular fibrocartilage complex tears. Swinging a racquet or bat causes increased load on the TFCC through forced ulnar deviance.
• Positive ulna variance. A situation where individuals have a longer ulna (forearm bone that is on the little finger side of the body). Ulna variance can contribute to this TFCC tears, because this anatomical variation puts more pressure on the TFCC.
• Age is a factor. Degenerative tears of the triangular fibrocartilage complex, are more common in people over 50 years old. As with many musculoskeletal conditions age is a contributing factor to injury. Over 50’s are 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 former years.

Diagnosing TFCC Tears

When looking clinically to diagnose the TFCC as a source of pain. Careful attention needs to be paid to the mechanism of injury. Specifically looking for a history of involvement in sports listed above, or any history of falls. Also as noted above any history of ongoing symptoms such as ‘pain rising 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/grinding sensations. These tests typically look to move the wrist into ulna deviation positions. Reproducing compression on the TFCC.
• 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 the presence of 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. Reserved for patients with ongoing functional limitation and persistent pain. Not resolved with conservative treatment, or inconclusive on prior investigations.

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.