What is the TFCC?
TFCC is a name given to a soft tissue structure that connects the distal aspects of the two bones in the forearm, namely the radius and ulna, around the wrist
Patients with traumatic tears present with a history of injury and pain on the ulnar side (inner side) of the wrist. In addition, they may have pain on forearm rotation, sense of abnormal movement (instability) at the wrist joint, weakness of grip, clicking and swelling around the distal ulna.
Simple activities such as turning a doorknob or lifting heavy objects can be painful.
Patients with undiagnosed TFCC problems usually give a history of long standing ulnar-sided (inner side of the wrist) pain which can be very disabling.
Initial treatment for both traumatic and degenerative TFCC tears is nonsurgical if the DRUJ is stable. This involves patients wearing a cast or a splint for a period of four-six weeks with the aim of helping the tear to heal and/or the surrounding soft tissues to scar. Usually anti-inflammatories are prescribed to help with pain management. A local anaesthesic and steroid injection may help in chronic settings.
Operative intervention is undertaken where conservative management has failed, there is instability (abnormal motion) at the DRUJ or there is a pull-off fracture of the TFCC with displaced wrist fracture.
The operative intervention is usually arthroscopic which primarily involves repair of the TFCC tear done through the arthroscopy (key hole surgery) although open repair may also be undertaken to address complex TFCC tears.
Return to activities of daily living
Most patients with a mild TFCC injury are able to return to work and/or return to sports at a pre-injury level. Pain-free movement and full strength are possible after both conservative and surgical treatments.
Return to driving: The hands need to have full control of the steering wheel with the left hand having control of the gear stick. It is advisable to delay return to driving until patients are pain free and can control a car comfortably in an emergency situation. This may take between four-six weeks, although each case is different.
Return to work: People are involved in different working environments. Return to heavy manual labour for example should be prevented for approximately 12 weeks and only when the wrist is pain free. Please ask your surgeon for advice regarding this.
Problems associated with acute TFCC tears could be due to delay in diagnosis and this can lead to continued pain, instability or weakness of the wrist.
Operative complications following TFCC repair include infection, injury to nerve or tendons around the operative site, incomplete relief of symptoms and in a few cases reflex sympathetic dystrophy (painful stiff hands).
For general complications of wrist surgery