Overview
what it is and why it mattersThe triangular fibrocartilage complex (TFCC) is a cartilage and ligament structure on the ulnar side of the wrist that stabilizes the distal radioulnar joint (DRUJ) and cushions load across the ulnar wrist. Tears are classified as traumatic (acute fall on outstretched hand, forearm rotation under load) or degenerative (age-related wear, especially with positive ulnar variance).
Symptoms are ulnar-sided wrist pain, clicking with forearm rotation, and DRUJ instability — a sense of the forearm bones shifting relative to each other.
Diagnosis
exam first, imaging secondThe fovea sign (tenderness in the groove between the ulnar styloid and the FCU tendon) and the DRUJ shuck test (dorsal-palmar stress of the ulna on the radius) are key exam findings. MRI arthrography is the most sensitive imaging test. Wrist arthroscopy is the gold standard for both diagnosis and treatment.
Treatment Path
how care progresses at OSI1
Long-arm splinting or casting
An immobilization phase with the forearm held in supination for acute tears, followed by a progressive motion phase once the ligament complex has stabilized.
2
Corticosteroid injection
Reduces synovitis and ulnar-sided pain in partial tears.
3
Physical therapy
DRUJ stabilization exercises after acute phase.
Surgical Options at OSI
if non-operative care isn't enoughSurgical management is indicated for complete tears with DRUJ instability, failed conservative treatment, or when the tear is associated with positive ulnar variance requiring correction.
Providers Who Treat Tfcc Tear
sports-medicine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: