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TFCC Injuries and Ulnar-Sided Wrist Pain
Understanding injuries to the triangular fibrocartilage complex (TFCC) and other causes of pain on the little-finger side of the wrist.
What is TFCC Injuries and Ulnar-Sided Wrist Pain?
The triangular fibrocartilage complex (TFCC) is a cartilage and ligament structure on the little-finger side of the wrist. It cushions and stabilises the joint between the two forearm bones and the wrist. An injury to the TFCC is one of several possible causes of what is broadly called ulnar-sided wrist pain, so an accurate diagnosis matters for choosing the right treatment.
TFCC Injuries and Ulnar-Sided Wrist Pain at a glance
What is it?
An injury to the TFCC, a cartilage and ligament structure that cushions the little-finger side of the wrist
Common symptoms
Pain on the little-finger side of the wrist, worse with gripping, twisting or pushing up from a chair
Who it affects
Can follow a fall or twisting injury, or develop gradually from wear and tear
Is it serious?
Not dangerous, but persistent pain can limit grip and forearm rotation if not addressed
Treatment options
Splinting, activity changes, injection, or surgery
First step
A consultation and examination, often with MRI, to confirm the diagnosis
Symptoms and how TFCC Injuries and Ulnar-Sided Wrist Pain presents
The main symptom is pain on the little-finger side of the wrist, worse with gripping, twisting movements such as turning a doorknob, or pushing up from a chair. Clicking or catching is common, and some people feel that the wrist is giving way.
Causes and risk factors for TFCC Injuries and Ulnar-Sided Wrist Pain
- A fall onto an outstretched hand
- A forceful twisting injury to the wrist
- Gradual wear and tear
- An ulna that is relatively longer than the radius
How is TFCC Injuries and Ulnar-Sided Wrist Pain diagnosed?
Diagnosis is based on examination, including specific tests that stress the TFCC, and imaging, usually an MRI, to confirm the diagnosis and show the pattern of injury.
Treatment options for TFCC Injuries and Ulnar-Sided Wrist Pain
Mild symptoms are often helped by activity modification, a wrist splint, and simple anti-inflammatory medication. An ultrasound guided corticosteroid injection can help in some cases.
If symptoms persist, surgery may be recommended, which can involve repairing or trimming the damaged tissue, and in some cases addressing an underlying difference in length between the two forearm bones (termed an ‘ulna shortening osteotomy‘).
When to see a hand surgeon about TFCC Injuries and Ulnar-Sided Wrist Pain
Persistent pain on the little-finger side of the wrist, particularly with gripping or twisting, that is not settling with rest and simple measures is worth assessing.
What to expect at your TFCC Injuries and Ulnar-Sided Wrist Pain appointment
At your appointment, Dr Tomlinson will examine your wrist, likely arrange an MRI if you have not already had one, and discuss the treatment options that suit your specific pattern of injury.
Frequently Asked Questions
What is it?
The triangular fibrocartilage complex (TFCC) is a cartilage and ligament structure on the little-finger side of the wrist. It cushions and stabilises the joint between the two forearm bones and the wrist. An injury to the TFCC is one of several possible causes of what is broadly called ulnar-sided wrist pain, so an accurate diagnosis matters for choosing the right treatment.
What causes it?
Causes include a fall onto an outstretched hand, a forceful twisting injury to the wrist, gradual wear and tear, or an ulna that is relatively longer than the radius.
What can I do myself?
Persistent pain on the little-finger side of the wrist, particularly with gripping or twisting, that is not settling with rest and simple measures is worth assessing. Mild symptoms are often helped by activity modification, a wrist splint, and simple anti-inflammatory medication.
What can a hand therapist do?
A hand therapist can help with splinting and activity modification advice to settle symptoms, and support rehabilitation of wrist movement and strength if surgery is needed.
What can a hand surgeon do?
Dr Tomlinson will examine your wrist, including specific tests that stress the TFCC, and arrange an MRI (if you have not had one) to confirm the diagnosis and show the pattern of injury. If symptoms persist despite splinting and activity changes, surgery may be recommended, which can involve repairing or trimming the damaged tissue, and in some cases addressing an underlying difference in length between the two forearm bones.
What happens if it's left untreated?
TFCC injuries aren’t dangerous, but persistent pain can limit grip and forearm rotation if not addressed. Persistent pain on the little-finger side of the wrist that isn’t settling is worth having assessed.
Related conditions and treatments
Ulnar-sided wrist pain can also come from a different ligament on the other side of the wrist, see wrist ligament injury and instability, or from wrist osteoarthritis.