What is the Tri-fibro Cartilage Complex (TFCC)? There is a rubbery cartilaginous triangular structure on the pinky side of the wrist that is prone to injury when we fall on an outstretched hand or when we sprain the twist with a twisting motion.
Why is it so difficult to diagnose? This structure cannot be seen on x-rays and is difficult to appreciate even with a sonar. Even with a MRI it can be difficult to appreciate these lesions as the tear is usually very small.
In older patients the TFCC can become torn or degenerated for other reasons. This is usually due to one of the fore arm bones (ulna), that form part of the wrist. This bone is a bit long and damages the TFCC. It can also irritates one of the small bones in the wrist known as the lunate.
How do we treat these lesions? Tears due to injury: Within the first few weeks after a TFCC the tear, the tear will heal if the wrist is immobilised in a cast. If too much time has passed then the choice would be to treat these lesions with the arthroscope. The tears secondary to injuries can be stitched up.
Tears due to wear and tear: The degenerative tears can be cleaned and trimmed with the arthroscope as well. Sometimes one would need to shorten the one bone of the forearm (ulna) as well to get full relief.
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