What Is the TFCC?
The triangular fibrocartilage complex (TFCC) is a structure on the ulnar (pinky) side of the wrist that serves as a cushion and stabilizer between the end of the ulna and the carpal bones. It also stabilizes the distal radioulnar joint (DRUJ), which allows forearm rotation. TFCC injuries are common in young athletes, workers performing rotational activities, and following wrist fractures.
Symptoms
- Pain on the pinky side of the wrist
- Worsening with forearm rotation (turning a doorknob, wringing a towel)
- Clicking or clunking with wrist motion
- Weakness of grip
- Wrist instability
Diagnosis
TFCC tears are difficult to see on plain X-rays. MRI with arthrogram is the imaging of choice. Arthroscopy remains the gold standard — allowing direct visualization and simultaneous treatment. Dr. Richards has a particular interest in ulnar-sided wrist pain, which requires specialized expertise to diagnose correctly.
Treatment
Many tears respond to cast or splint immobilization, corticosteroid injection, and rehabilitation. For peripheral tears with healing potential, arthroscopic repair restores stability. Central tears can be debrided arthroscopically. Cases with DRUJ instability may require formal ligament reconstruction.