TFCC Replacements
Problem
- Pain and clicking on the ulna side of the wrist
Cause
- The triangular fibro cartilage complex (TFCC) has a tear that has failed to heal.
Diagnosis
- Ulna sided wrist pain
- Localised pain in this area ‘ulna side of wrist’
- Pain and clicking with circumduction
- X-rays often normal, may show ulna styloid fragment
- MRI Scan – increasingly effective at diagnosing tears
- Arthroscopy confirms the diagnosis
- Small tears can be debrided
Treatment
- Surgical
- General Anaesthetic
- Usually diagnostic wrist arthroscopy first
- Small tears and central tears can be debrided arthroscopically
- Large peripheral tears that fail to heal can be repaired usually through a small open approach, using a suture anchor to stabilize the cartilage
- Occasionally the ulna will need to be shortened.
Potential Complications
- Infection, Haematoma, Neurovascular Injury
- Stiffness – loss of supination/pronation
Post Op Care
- Above Elbow cast
- Sugar Tong splint for six weeks, prevents supination/pronation.
- Hand Therapy for strengthening.
