The triangular fibrocartilage complex (TFCC) is a complex of tissues - cartilage and ligaments - located near the outer region of the wrist, below the little finger. The complex stabilizes the wrist, allows easy movement and acts as a shock absorber. Sports activities or falls can damage or injure the TFCC, causing wrist pain and instability. The injured TFCC complex may also produce a clicking sound with certain wrist movements.
TFCC injuries can be repaired by open or arthroscopic methods.
Arthroscopic TFCC repair: The arthroscopic technique is a less invasive procedure where 2 to 3 incisions of about 5 mm each are made in the wrist, through which a telescope (arthroscope) and other surgical instruments are passed. Repair is based on the damage caused to the ligament and cartilage. Simple tears in the cartilage are repaired by debriding (removal of dead or damaged tissues). Sometimes, tears are sutured and reattached. Ligamentous ruptures are reattached using sutures, and inserting screws and wires to stabilize the region until complete healing.
Open TFCC repair: Open repair is considered for complex tears. A larger incision is made down the wrist to gain a better view and access to the site of injury. Repair is based on the damage caused to the ligaments and cartilage. Ligaments may be reattached and bone joints may be stabilized with wires. In chronic and degenerative injuries, the load on the TFCC side of the wrist is decreased by shortening the ulnar (bone of the forearm that attaches to the wrist).
After surgery, your wrist will be bandaged and it should be kept elevated for 2 to 3 days. Your wrist will be placed in a splint for about 2 to 6 weeks. Your doctor may prescribe medication to relieve pain and discomfort. You can apply ice to reduce the swelling. You will be taught strengthening and stretching exercises to regain range-of-motion of the wrist. It is recommended that you avoid driving for at least 2 months after the surgery. Recovery is faster after arthroscopic surgery when compared to the open technique. Being minimally invasive, the arthroscopic procedure is associated with a shorter hospital stay and less post-procedural pain and scar formation.
Like most surgeries TFCC repair surgeries may be associated with risks such as:
- Infection at the site of the surgery
- Nerve and tendon damage
- Swelling, stiffness and scar pain
- Failure of repair