TFCC Tear Treatment in Dallas, Frisco, Prosper, and Wylie, TX
Ulnar-Sided Wrist Pain, Triangular Fibrocartilage Complex Tear Treatment
Painful triangular fibrocartilage complex rips might limit a person’s ability to utilize their hand or wrist. But what precisely is a TFCC tear? What is the treatment for this injury? Understanding what this injury is and how to recognize its symptoms will help you go back to living pain-free sooner. That’s why it’s important to consult with a Dallas orthopedic surgeon.
At SPORT Orthopedics + Physical Therapy, our orthopedic and physical therapy specialists have extensive experience in their field. We offer a variety of treatment options for an even wider variety of conditions.
To schedule your appointment with us, please call 469-200-2832 or fill out our online intake form today.
TFCC Anatomy
The triangular fibrocartilage complex (TFCC) is a critical structure in the wrist that provides stability and support. It consists of several components, including the triangular fibrocartilage, the ulnar collateral ligament, the ulnar meniscus homologue, and the sheath of the extensor carpi ulnaris tendon.
Triangular Fibrocartilage: This is a thick, triangular-shaped piece of cartilage located on the ulnar side of the wrist. It bridges the gap between the ulna and the wrist bones, providing cushioning and stability.
Ulnar Collateral Ligament: This ligament connects the ulna to the triangular fibrocartilage and helps to stabilize the wrist joint.
Ulnar Meniscus Homologue: This structure is located on the ulnar side of the wrist and helps to distribute forces across the wrist joint.
Sheath of Extensor Carpi Ulnaris Tendon: This sheath surrounds the tendon of the extensor carpi ulnaris muscle, providing protection and support.
What Is a TFCC Tear?
The wrist is formed by the triangular fibrocartilage complex (TFCC), which links the hand and forearm bones. Several ligaments, tendons, and cartilage make up your TFCC. When gripping something with your hand or twisting your forearm, it aids wrist movement and stabilizes the forearm. Any injury or damage to the TFCC is referred to as a TFCC tear. The two forms of TFCC tears are described here.
- Type 1: A physical damage causes these rips. When a person overextends their wrist or falls on their hand while it is outstretched, this might happen. These are called traumatic TFCC tears.
- Type 2: These tears develop over time and might be caused by aging or an underlying health problem such as gout or rheumatoid arthritis. These are called degenerative TFCC tears.
TFCC Sprain vs Tear
A TFCC sprain and a TFCC tear both refer to TFCC injuries in the wrist, but they differ in severity and the nature of the damage. A TFCC sprain is a milder injury characterized by the stretching or slight tearing of the fibrous tissue within the complex, often resulting in pain, swelling, and limited wrist function, but maintaining the overall integrity of the TFCC structure.
A TFCC tear involves a more significant rupture of the fibrocartilage or associated ligaments, leading to greater instability, pronounced pain, and a more substantial impairment of wrist function.
While sprains may recover with rest and conservative treatment, tears often require more intensive interventions, such as immobilization, physical therapy, or even surgery to restore wrist stability and function.
What Causes TFCC Tears?
A TFCC tear can occur in two places and is typically caused by distinct issues. Natural wear causes the first form of TFCC tear, whereas damage causes the second. Wear-related tears are the most prevalent, although they are rarely observed in younger people. As one grows older, they become more prevalent. TFCC tears and injuries come from the following.
- Falls onto the wrist or hand
- Twisting injuries, such as those that occur from a caught drill bit or anything else that twists the arm
- Radius fractures at the end of the bone
TFCC Tear Risk Factors
The wrist is one of the body’s most complicated joints. Because of this, it is prone to wrist sprains and injuries. Physical trauma, heavy usage, or the aging process can also cause TFCC tears. The following factors can enhance a person’s chance of having a TFCC tear.
- Age: As a person gets older, TFCC tears become more prevalent. This might be due to normal wear and tear, or because the body’s ability to heal TFCC damage deteriorates.
- Chronic inflammation: Inflammatory diseases like rheumatoid arthritis and gout can cause wrist damage over time. TFCC tears were observed in 38.9% of individuals with severe rheumatoid arthritis, according to a small retrospective research.
- Sports: Wrist injuries are more common among athletes that participate in sports like baseball, football, or tennis. According to research, the hand or wrist is involved in about 25% of all sports injuries, whether in a wrist fracture or otherwise.
- Positive ulnar variance: Ulnar deviation occurs when the joints swell and the fingers abnormally bend toward the pinky finger. This can happen after frequently swinging a bat or racket in sports. Positive ulnar variance is another risk factor of TFCC injuries. This means that the ulna is longer compared to the radius.
TFCC Tear Symptoms
Wrist pain is a typical symptom of TFCC tears. The discomfort may be persistent or present just when you apply pressure or move your wrist. The following are some of the other signs and symptoms of a TFCC tear.
- Stiffness or weakness in the wrist
- Limited range of motion in the wrist or hand
- Swelling of the wrist
- Loss of grip strength
- Popping or clicking sound as you move your wrist
Tennis players and gymnasts are at a higher risk of developing a TFCC tear because they apply strain on their wrists on a frequent basis. If you’ve previously hurt your wrist, you’re at a higher risk of a TFCC tear.
Can a TFCC Tear Cause Elbow Pain?
A TFCC tear typically does not cause elbow pain directly, as it is a wrist-specific injury affecting the triangular fibrocartilage complex located on the ulnar side of the wrist. However, individuals with a TFCC tear may alter their arm movements to compensate for wrist pain and instability, potentially leading to abnormal stress and strain on the elbow. This compensatory behavior can result in secondary discomfort or pain in the elbow area. Nevertheless, the primary symptoms of a TFCC tear are usually localized to the wrist.
Can a TFCC Tear Get Worse?
Yes, a TFCC tear can worsen if left untreated or if activities that aggravate the injury are continued. Without proper care, such as rest, immobilization, and rehabilitation, the tear may become larger or more severe over time.
Additionally, repeated stress or trauma to the wrist can exacerbate the tear, leading to severe pain, instability, and potentially further damage to the surrounding structures. Early intervention and appropriate management are crucial to prevent the worsening of a TFCC tear.
How to Diagnose a TFCC Tear
The fovea test, also known as the ulnar fovea sign, is frequently used to identify TFCC tears. Your doctor will do this by applying pressure to the outside of your wrist and asking whether you experience any discomfort or soreness. For comparison, they’ll perform the same thing on your unaffected wrist.
You could also be requested to do a series of wrist motions. Rotating your forearm or shifting your hand away from your thumb are two examples. An X-ray may be used by your doctor to ensure that you don’t have any fractured bones in your hand or forearm.
TFCC Tear MRI
One of the more effective ways to have a TFCC tear diagnosed is with an MRI. An MRI can effectively diagnose this condition by providing detailed images of the soft tissues in the wrist. During the scan, special sequences can specifically highlight the TFCC and surrounding structures.
This can eliminate other potential diagnoses, such as wrist sprains or ulnar styloid impingement syndrome. Radiologists and orthopedic specialists look for tears, disruptions, or inflammation within the TFCC.
TFCC Tear Test
Even when the patient has little or no pain, orthopedic specialists can use a variety of diagnostic techniques to evaluate the amount of damage or the extent of a tear. TFCC can be less painful than it appears, and some very advanced diagnostic procedures are used to better diagnose and treat injuries, as well as age-related wrist degeneration. Weight-bearing tests and a number of imaging techniques are among the diagnostic procedures available.
- Utilizing increasing weight loads as a metric for injury severity
- Lifting and gripping exercises to determine what you can accomplish without pain
- Visual tests including observing for swelling, discoloration, and bone placements
- MRI (magnetic resonance imaging) which allows for scans of the soft tissues
- MRA (magnetic resonance angiogram) often serves as a complement for the MRI in viewing soft tissue injuries
TFCC Tear Treatment Options
The kind, origin, and severity of the injury determine the treatment choices for TFCC tears. A TFCC rupture will usually heal on its own. To minimize additional harm and to allow the afflicted wrist to recover correctly, a person must stop using it.
Non-Surgical Treatment
To protect and immobilize the wrist, a healthcare practitioner may prescribe wearing a splint, brace, or cast. They may also recommend pain relievers like ibuprofen or steroid injections to aid with swelling and discomfort.
Some patients with TFCC tears may benefit from physical therapy in Dallas. For the damaged wrist, a physical therapist will lead the patient through some moderate stretches, exercises, and activity modifications that seek to accomplish the following.
- Reduce swelling and pain
- Increase range of motion and improve flexibility
- Increase strength
TFCC Tear Exercises
There are various exercises you may do at home to aid the healing process when recovering from a TFCC tear. The following are some exercises we recommend.
- Move your wrist in circular motions, both clockwise and counterclockwise.
- Stretch the wrist back toward the forearm. Then stretch it forward in the opposite direction.
- Flex the wrist against a hard surface.
- Repeatedly grip a tennis ball.
To prevent overexerting your wrist, start by doing only a few of these exercises at a time. Stop doing any of the motions if they cause significant discomfort. Depending on your health, your doctor can also go through some safe home workouts with you.
TFCC Tear Brace
Wearing a brace can help with a TFCC tear by providing support and stability to the wrist joint, reducing excessive movement that could exacerbate the tear. The brace can also help to immobilize the wrist, allowing the TFCC to heal properly by minimizing stress on the injured area. Additionally, a brace may alleviate pain and discomfort associated with degenerative TFCC tears by providing compression and restricting movement that triggers symptoms.
TFCC Tear Surgery
A doctor may prescribe surgery for patients who have severe or recurring TFCC tears. A sort of minimally invasive technique known as wrist arthroscopy is one surgical possibility. Another possibility is arthroscopic debridement, which involves removing any loose material in the joint and smoothing the joint’s surfaces.
A surgeon will make a series of tiny incisions on the outside border of the wrist during an arthroscopy to treat the damage to the TFCC. They may also shorten the ulna to help with the symptoms. This is referred to as an ulnar shortening osteotomy. Following surgery, your doctor will recommend immobilizing the wrist for up to 6 weeks.
Is TFCC Surgery Worth It?
TFCC surgery may be worth considering if conservative treatments fail to alleviate symptoms and if the tear significantly impairs wrist function and quality of life. It can help repair the damaged TFCC, restore stability, and reduce pain, especially in cases of severe tears or persistent symptoms.
It’s important to note that not all surgical solutions involve open, disruptive techniques. Arthroscopic repair is a very popular and common option that involves a very small incision with minimal disturbance of the surrounding tissue.
What Is the TFCC Tear Recovery Time?
Recovery time for TFCC tears that do not require surgery is generally four to six weeks. If surgery is required, it might take anywhere from six weeks to several months to restore full wrist function. Physical therapy and avoiding activities that put a pressure on your wrist might help you heal faster.
What Is the Outlook for Someone with a TFCC Tear?
While most individuals heal completely from a TFCC rupture with physical therapy or surgery, you may experience minor discomfort or stiffness in your wrist for years. Manage any lingering pain or stiffness with the help of your doctor. You may need to wear a brace while completing specific chores or continue with physical therapy, depending on your level of pain.
What Are Possible Complications of a TFCC Tear?
Following surgery for TFCC rips, complications can be multiple and vary depending on the location and degree of the tear as well as the surgical technique performed. When instrumentation is utilized or one of the forearm bones is shortened, for example, the risk of complications is greater. The more significant issues that might arise include delayed union, nonunion, infection, and chronic wrist discomfort and stiffness.
Nerve damage that occurs during surgery can result in long-term numbness, weakness, and loss of hand function. It’s possible that the initial operation will need to be revised. Some individuals will require further surgery to remove any joint-stabilizing devices.
The styloid, which is located at the bottom of the ulna, may need to be removed. In a small percentage of cases, the technique does not produce the intended results. The next stage might be a wrist fusion.
What Happens If a TFCC Tear Goes Untreated?
If TFCC injuries go untreated, they can lead to persistent wrist pain, weakness, and instability. Without intervention, tears may worsen over time, potentially causing further damage to the surrounding structures, such as ligaments and cartilage.
Untreated TFCC tears can also impair wrist function, limit daily activities, and decrease quality of life. Additionally, chronic untreated tears may eventually require more invasive treatments, such as surgery, to address the damage and restore wrist stability and function.
Contact SPORT Orthopedics + Physical Therapy Today for TFCC Injury Treatment in Dallas
Tears in the TFCC are frequently unpleasant and can impair a person’s ability to utilize their hand or wrist. Sports injuries, wrist overuse, and inflammatory diseases like rheumatoid arthritis can all cause them. TFCC tears are more prevalent among the elderly. TFCC rips usually heal on their own, but a person must avoid using their wrist while the damage heals.
A doctor may prescribe surgery or physical treatment if the tears are serious or chronic. To schedule an appointment with an orthopedic specialist, please call 469-200-2832 or fill out our online intake form today.
