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What is TFCC (Triangulair Fibrocartilage Complex?

More popularly known as the wrist meniscus; a kind of shock absorber for some of the joints in your wrist. The TFCC can tear with rotational movements (hyper rotation whilst using a drill), excessive weight bearing, a fall on an outstretched hand etc.  There is an interesting subset of patients that develop a TFCC tear for no reason at all.  Suddenly out of nowhere, their wrist starts to hurt.  This group of patients fascinate me.  In close analysis and discussion with these patients, there is a common thread- the stomach.  This is a broad statement which was later confirmed when discussing cases with acupuncturists and naturopathic practitioners.  This demands further understanding and investigation. 

 

What does it do?

The TFCC is the main stabilizer of the wrist.  It is a ligament connecting bone to bone.  It supports the wrist with grip, weight bearing and rotation (supination and pronation)

 

My wrist hurts, how do I know if it’s the TFCC?

Some common signs and symptoms of a TFCC tear are:

• Pain, localized to the ulnar (pinky) side

• Pain that gets worse with simple gripping and rotation movements (opening a door or using a can opener)

• It normally does not swell. 

• Clicking, snapping, or crackling (crepitus) These are not present in all patients with TFCC tears. 

• Pain with weight bearing activities. 

• Feeling of instability

A TFCC definitive diagnosis takes history, mechanism of injury, and imaging. The gold standard for imaging is an arthrogram.  This test involves injecting a dye into the wrist and imaging to determine if the dye leaks into the joint.  This is an invasive and expensive study so most physicians order an MRI first.  MRI's are helpful but not always accurate.  This variable and difficulty in diagnosing a TFCC tear, inspired me to create and objective and reliable test that anyone can perform at home using an inexpensive non digital scale.   I have learned that it is a priceless tool to assess the wrist.  The most accurate way to determine damage is our TFCC tear test.