TFCC (triangular fibrocartilage complex) repair is an arthroscopic operation to fix a tear in the cartilage and ligament complex on the ulnar (little finger) side of the wrist. The TFCC is a critical stabiliser and shock absorber.
Performed arthroscopically through small portals on the wrist. The torn TFCC is identified, debrided (trimmed) if it is a degenerative tear, or repaired with sutures if it is a peripheral (outer) tear with healing potential. The operation takes 45–90 minutes.
Surgery is recommended for TFCC tears causing persistent ulnar-sided wrist pain, clicking, or instability that has not responded to splinting, activity modification, and corticosteroid injection.
Wrist splinting, activity modification, corticosteroid injection, and physiotherapy. Many TFCC tears improve with conservative management.
MRI or MR arthrogram to confirm the tear. Day-case procedure.
Debridement provides good pain relief for central tears. Repair of peripheral tears restores DRUJ stability. Approximately 80% of patients report good outcomes.
Temporary loss of motion, especially after repair.
Wrist swelling for several weeks.
The repair may not heal.
DRUJ instability may persist.
Dorsal sensory branch of ulnar nerve.
Extensor tendons near the portals.
Joint infection.
General or regional anaesthesia.
Debridement: splint for one to two weeks, then exercises. Repair: cast for four to six weeks, then physiotherapy. Return to full activity at three to four months after repair.
Reviews at two weeks and six weeks.
The triangular fibrocartilage complex is a cushion and stabiliser between the ulna and the carpal bones. It allows the wrist to rotate and absorbs forces during gripping.