1. Triangular Fibrocartilage Complex (TFCC)
Emma Galante 1st pd Sports Medicine

2. TFCC: Structure and Location
A cartilage structure located on the ulnar side of the wrist.
Triangular shape
Biconcave body
Periphery is thicker than the center disk

3. TFCC: Structure and Location (continued)
Blood Supply:
Center: Little to none
Outside: Moderate to good
Origin: Sigmoid notch of the radius
Insertion: Ulnar styloid process

4. TFCC: Function
Absorbs 20% of an axial load on the wrist joint
Cushions/supports carpal bones
Stabilizes radius and ulna during pronation, supination, and grasping motions

5. TFCC Tears: Types, Cause, and Who is Vulnerable
Trauma
Excessive arm rotation
Falling on an outstretched arm
Athletes using a bat, racquet, or club
Athletes in sports that require weight-bearing
Type 2
Degenerative
Typically chronic
Causes by time, age, and repetitive injury
People over 50
Can cause inflammatory disorders (ex. Arthritis)

6. TFCC Tear Symptoms
Pain at base of pinky side of wrist
Pair worsens with pronation, supination, and ulnar deviation
Swelling
Audible, painful “Clicking” or “Grinding” is reported
Loss of grip strength
Pain both while moving and still
Pain with weight-bearing

7. OUR PATIENT
Female
14 years old
Severe pain through left wrist
Sports:
Softball
Gymnastics

8. HOP
History
Observation
Palpation

9. HOP: History
MOI: “Pain for roughly 3 years, worked through it until it got worse and ‘gave out’ one day at practice”
Previous injuries: “Broke right wrist as a child, several other injuries but not to left wrist”
Location of pain: “From the pinky side of the wrist through to the middle of the anterior side of wrist”

10. HOP: Observation
Swelling: Visible swelling that obscures the ulnar head
Discoloration: Slightly red and hot to the touch
Carrying angle: Patient guards close to body and avoids deviation from neutral position

11. HOP: Palpations
Palpate scaphoid/snuffbox
Slight discomfort, but nothing severe
Palpate ulnar styloid and radial sigmoid notch
Intense pain with both

12. Special Tests Press Test
Patient sits in a chair and attempts to lift themselves up by providing a downward force through the wrist
Positive= ulnar-sided pain
Shear Test
Provide an axial load while passively pronate, supinate, ulnar deviation
Positive = pain/clicking

13. Neurological Tests Tinel’s Sign Examiner taps over median nerve
Positive = tingling through the pinky
Phalen’s Test
Positive = numbness/tingling

14. PATH TO RECOVERY Months of physical therapy are prescribed
Immobilization is ordered until an MRI is done
MRI reveals surgery is needed

16. Citations
Injuries
fibrocartilage-complex-tear
pedia.com/Triangular_Fibrocartilage_Complex_Injuries