Triangular Fibrocartilage Complex Injury – What are the ‘wrists’?

Are you currently experiencing medial wrist pain or suffered a wrist sprain that never fully recovered? It might be a more complex matter than just a sprain. Triangular Fibrocartilage Complex (TFCC) tears are common problems I see in workplace injuries; I find that TFCC injury is often dismissed as wrist sprain. TFCC is a triangular shaped cartilage structure located on the medial side of the wrist that acts as a shock absorber, helps stabilise the wrist and enables smooth movement of the wrist joint. The central 80% of the TFCC has very limited to no blood supply, thus, tears in this region have a slow healing process.

Individuals are most at risk for type 1 traumatic TFCC tears are those who sustained a fall onto an outreached hand, excessive arm rotation or pulling movements such as when using heavy tools, and those who participate in sports that involve a racket or a bat. Individuals at risk for type 2 degenerative TFCC tears are those suffering from inflammatory disorders such as rheumatoid arthritis or gout, those with previous distal radius or distal ulnar fractures, and those with congenital abnormalities in which the ulna is longer than the radius. This increases the loading forces on the TFCC by up to 40%, which significantly increases your risk of sustaining a TFCC tear. The incidence of type 2 tears also increases with age. One study indicated that degenerative TFFC tears were present in 7.6% of individuals up to 30 years old, 40% aged 50 years and 53.1% in individuals older than 60 years old.

Conservative management of a TFCC injury consists of a period of immobilisation, which is followed by improving range of motion (ROM) of the wrist. Active assistive ROM is initially implemented followed by passive ROM exercises. Strengthening based exercises are progressed from isometric, stability and proprioception exercises to isotonic exercises emphasising on eccentric loading. At the final stages of exercise rehabilitation, a gradual progression to weight-bearing loads to the upper limbs and correct manual handling technique are incorporated to reduce the risk of re-injury.

If you, or someone you know are suffering from wrist pain or have been diagnosed with a TFCC tear, contact an Exercise Physiologist at Absolute Balance for a smooth recovery. You can contact us at info@absolutebalance.com.au

daniel-n

Daniel Nguyen (B.Sc. Exercise Physiology)

Accredited Exercise Physiologist (AES, AEP)(ESSAM)

P 9244 5580 – M 0428 199 908 – F 9244 5582

 

References

Zlatkin, Michael B., and Joel Rosner. “MRI Imaging of Ligaments and Triangular Fibrocartilage Complex of the Wrist.” Radiologic Clinics of North America 44 4 (2006): 595-623.

Gary E. Mcllvain, E. L., Neil A. Evans, P. D., & and Suzanne M. Konz. (2013). Recognition and Management of Triangular Fibrocartilage Complex Injury. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY & TRAINING, 37-42.