Understanding TFCC: Anatomy, Function, and Injury Mechanisms
The Triangular Fibrocartilage Complex (TFCC) is an important part of your wrist that helps keep it stable and supports your ability to carry things. It’s made up of different parts like discs and ligaments, and because it doesn’t have many blood vessels, it can easily get hurt. TFCC injuries usually happen from accidents or overusing your wrist, and they can either be sudden tears from bending your wrist too far or long-term tears from doing the same movements over and over.
What is Triangular fibrocartilage complex (TFCC)?
The Triangular fibrocartilage complex (TFCC) is located between the Triquetrum, Lunate, ulna styloid.(1) It is made up of 8 structures involving the fibrocartilaginous disc, meniscal homologue, ECU tendon subsheath, ulnocarpal ligament, lunotriquetral ligament, ulnolunate ligament, palmar and dorsal radialulna ligament. (1,2) The radial aspect of the TFCC is attached to the hayline cartilage, making this weaker than boney attachment to fovea on the ulna side. (1) The structure is largely avascular, with the exception of the periphery of the disc.(1)
The TFCC acts as the primary stabiliser of the ulna sider wrist and distal radio-ulna joint, as well as having a stabilising role while loading bearing. (1) In a neutral wrist, the ulna bears 20% of forces, while the radiocarpal joint accounts for the remaining 80%. (2)
Exploring TFCC Injury Causes and Mechanisms
TFCC can become injured with sustained or traumatic mechanisms. The usual mechanism involves ulna deviation, supination or axial loading and a combination thereof. (1) Movements that involve repetitive rotation (pronation/supination) of the wrist are also aggravating for the ulna sided wrist.(1) This explained by the fact that supination momentarily increases ulnar variance, thereby increasing forces on the ulnocarpal joint greater than 20%. (1,2).
Acute TFCC tears occur with hyperextension and pronation of the axially loaded, in an ulnar deviated wrist. (2) Contrastly, chronic repetitive trauma can cause peripheral tears, usually involving rapid supination-pronation of the ulnar deviated wrist. (2)
Symptoms of Ulna-Sided Wrist Pain
Demographically, a 2019 systematic review found that ulna-sided wrist pain is prevalent in groups involved with daily physically demanding activities such as manual labourers or the sporting population (3). It is, however, less prevalent in the general population. (3)
Patients with TFCC injury will present with ulnar-sided wrist pain that may involve mechanical symptoms of clicking with wrist rotation or pin-point tenderness over the ulna fovea. (1,2) They may also experience pain with gripping or axial loading tasks. Painful symptoms can range from a deep ache to sharp pain. (1,2)
Alleviate Ulna-Sided Wrist Pain with Action Rehab Hand Therapy’s Tailored Programs!
For comprehensive assessment and treatment of TFCC injuries, consider consulting with Action Rehab Hand Therapy. Our experienced therapists offer tailored rehabilitation programs to alleviate ulna-sided wrist pain and restore functionality. Contact us today to schedule a consultation and start your journey towards recovery.
—
References:
- Casadei K, Kiel J. Triangular Fibrocartilage Complex. [Updated 2022 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537055/
- Avery DM, Rodner CM, Edgar CM. Sports-related wrist and hand injuries: a review. Journal of orthopaedic surgery and research. 2016 Dec;11(1):1-5.
- Ferguson R, Riley ND, Wijendra A, Thurley N, Carr AJ. Wrist pain: a systematic review of prevalence and risk factors–what is the role of occupation and activity?. BMC musculoskeletal disorders. 2019 Dec;20(1):1-3.
