The wrist joint contains cartilage called triangular fibrocartilage complex or TFCC. This cartilage is located on the wrist’s inside or ulnar aspect. Sometimes, TFCC injury or triangular wrist cartilage tears can cause wrist pain and clicking. So, what are the options for treating a wrist cartilage tear?

What is the TFCC? 

 

wrist cartilage tear

The TFCC is a complex structure that attaches to the bones inside the wrist. It is no surprise that it’s a rigid structure, given the complicated movements of the wrist. The wrist joint bends forwards and backward, sidewards, and rotates. It allows fine movements of the hand but also provides stability and strength.

The TFCC comprises cartilage surrounded by stabilising ligaments at the front and back. A TFCC injury consisting of a tear of the TFCC can involve any or all structures. In addition, some tears are small and stable, while others are larger and unstable. Therefore, not all TFCC tears are treated the same.

Causes of a TFCC injury or wrist cartilage tear

The most common cause of a wrist cartilage tear is a fall directly onto the hand. Other mechanisms of a TFCC injury include a forced rotation or distraction (pull), such as occurs in boxing, tennis, squash, or weight training.

Sometimes, no specific injury to the wrist causes a TFCC injury. However, initially, people notice a clicking followed by a gradual onset of pain.

Symptoms of a wrist cartilage tear

The most common symptoms of a TFCC injury include:

  • pain on the inside (ulnar) of the wrist
  • pain with twisting (tennis) or pressure on the wrist (weight training)
  • clicking in wrist
  • loss of grip strength

It is essential to see your doctor to confirm the diagnosis and exclude other wrist problems. In addition, it is necessary to assess the stability of the wrist as larger tears cause excess movements of the bones and joints of the wrist (distal radioulnar joint).

If we think there is an injury to the TFCC, X-rays are performed to assess the position of the bones (whether one is longer than the other) and exclude a break or fracture. Additionally, a 3T MRI is helpful to picture the cartilage and ligaments. Sometimes, the cause of wrist pain is due to other problems such as arthritis or wrist tendonitis.

Treatment of a TFCC injury or wrist cartilage tear

wrist splint

As the TFCC is a complex structure, it is essential to modify your activity to allow a TFCC injury to heal. Generally, we recommend you wear a brace for 4-6 weeks. Once the pain settles, you should start an exercise program to stretch and strengthen the wrist.

Sometimes, a cortisone injection into the wrist joint is helpful to reduce pain and allow for hand therapy.

Finally, keyhole surgery may be needed to repair structures for more giant tears with instability. Also, bone shortening may be necessary if one bone is longer than the other (ulnar variance).

More on cortisone injections for a triangular wrist cartilage tear

Cortisone injections can help with pain and inflammation from TFCC tears. Cortisone is a potent anti-inflammatory and should be directed to the exact site of the tear. Moreover, it is vital to use ultrasound guidance to improve the accuracy of the injection.

An ultrasound-guided injection reduces pain and allows people to progress in their rehab. Overall, the combination of an injection and recovery is very effective.

Final word from Sportdoctorlondon about wrist cartilage tear

Dr. Masci is an expert in ultrasound-guided injections and performs injections in some cases of a TFCC tear. He can diagnose a TFCC tear and advise on treatment, including a referral to a hand surgeon if he thinks surgery is needed.

Other hand conditions:

Dr. Masci is a specialist sport doctor in London. 

He specialises in muscle, tendon and joint injuries.