Triangular Fibrocartilage Complex Tears of the wrist (TFCC)
The TFCC is the analogues structure in the wrist as the meniscus is to the knee. It is also the most commonly torn soft tissue structure in the wrist much like the knee meniscus In similar fashion, torn fibers of this critical structure often lead to pain, inflammation, and loss of strength in the hand and wrist. The TFCC tear is one of the most common causes for unexplained persistent wrist pain and is frequently detected in patients who have trouble in rotating the wrist and who have lost strength. This is commonly seen in racquet sport athletes, such as tennis players, and even golfers, but can often be seen in laborers and people who injured the wrist in a fall or motor vehicle accident.
Traditional open surgeries on the ulnar, or pinky, side of the wrist have been used to repair or débride (scrape) the TFCC cartilage lesion. The open procedure obviously implies a much longer recovery with a large and occasionally painful scar. The open procedure also does not permit good visualization since this is a very small structure and this open procedure necessitates division of critical structures that lead to later stiffness and potential wrist limitations. While MRI imaging can often assist in making the diagnosis, it usually requires arthroscopy
to confirm the presence of the lesion and to repair it, which can all be done in a single outpatient minor surgical procedure.
Arthroscopy, which is the minimally invasive use of a fiberoptic instrument to look inside the joint, allows the surgeon to better evaluate the TFCC structure and decide if this is a tear that requires debridement (scraping) or actual suture repair of the structure. The procedure will also determine in any other structures, such as a ligament or the capsule is injured, allowing for more complete treatment. Your surgeon will determine this intraoperatively and the period of immobilization will depend much upon the nature of the cartilage tear and how it was repaired.
