There are some scenarios where surgery may be considered for treatment. The goal is to promote healing without the need for surgery. 2019 Feb;477(2):442-449. doi: 10.1097/CORR.0000000000000533. If the TFCC tear is severe or involves multiple injuries, the surgeon may need to repair it with metal pins, screws or other fixation devices. A camera is inserted into the wrist joint and the image is projected onto a television screen. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. Most people are aware of the “meniscus” which cushions and stabilizes the knee – the TFCC is a very similar structure in the wrist. In summary, rehabilitation for TFCC injury should consist of enough resting, appropriate protection, additional supports and strengthening exercises. C. Shaver is inserted into the wrist joint to trim away the torn edges of the TFCC tear (like a lawn mower). Briefly, Class 1 lesions have a reparable isolated dc-TFCC tear, a normal … (303) 429-6448 Mild injuries of the TFCC may be referred to as a wrist sprain. doi: 10.1097/PRS.0000000000003750, (9) Jung KJ, Nho JH2, Kim JH2, Kim BS3, Gong HS4. I now lift heavy weights without any issue and instead of being in a big cast or brace, I was able to return to work immediately and had an active recovery. 1996;21:406–411. Non-operative care is an option for a TFCC tear, but if the tear is extensive, surgery may be required. Debridement in one study didn’t produce better grip strength or pain relief (6). TFCC Tear. For cases where the TFCC tear is severe and surgery is required to fix it then the time taken to heal will be longer. Open surgery. After TFCC tear surgery, patients will wear a cast to keep their wrist, hand, and forearm stabilized. (11). I stopped the training and try to rest etc. When the TFCC is torn or injured, patients experience pain along the pinky finger side of the wrist. In yet another, tears that were due to wear and tear and those patients who had a long ulnar bone were associated with poor surgical results. Recovering from TFCC injury (wrist surgery) I injured my wrist about a year ago at wing tsun training. Lone Tree, CO 80124 A. Depending on the location of the tear in your TFCC, your physician may recommend surgery. Suite 201 You will be expected to begin using your fingers as soon as possible and while in a splint to keep them from getting stiff. They work together to stabilize the very mobile wrist joint. firstname.lastname@example.org. Let’s dig in. The TFCC, or triangular fibrocartilage complex, is a structure in your wrist. Arthroscopy. Tears due to wear are the most common and are usually not seen in younger people. email@example.com, South Denver VIEW PROFILE, Broomfield The TFCC tear results in chronic pain in your wrist. An injured TFCC causes pain and may produce a clicking noise when the wrist is moved in certain ways. If these become stretched and allow too much movement, this is called instability. This complex of ligaments stabilizes the bones on that side and adds cushioning. Some areas of the TFCC have excellent blood supply and are amenable to healing. What Is the Recovery Time for Wrist Surgery? Surgery is indicated in-Type 1- acute unstable injury What is a TFCC tear and does it need surgery? Icing 3-5 times a day is used to reduce swelling for the first few weeks. Arthroscopy. A TFCC injury can be a very disabling wrist conditio… 1996;12:588–597. TFCC tears can be diagnosed by talking with your doctor and having them examine your wrist. Am. Surgical treatment will “clean” the damaged cartilage by tidying up the torn edges of the cartilage, or it will repair the tear entirely. After this period a removable splint may be used which permits some movement. Both can be done with open surgery or arthroscopy (using a “scope” as in the picture above). It is a more invasive surgical technique compared to arthroscopic treatment, but the surgeon has better visibility and access to the TFCC. Broomfield, CO 80021 TFCC tears can be painful and frustrating and many times surgery is recommended. Prognostic Factors of Arthroscopic Debridement for Central Triangular Fibrocartilage Complex Tears in Adults Younger Than 45 Years: A Retrospective Case Series Analysis. TFCC injuries can be repaired by open or arthroscopic methods. Progressive mobility and strengthening exercises should be followed, as pain allows. Access all of our downloadable e-books from the Regenexx Library free of charge! As with many injuries or conditions, the ideal option is to treat TFCC injuries conservatively to avoid unnecessary surgery. After the cast is removed, patients will undergo physical … https://www.ncbi.nlm.nih.gov/pubmed/8169359, (6) Nishizuka T, Tatebe M, Hirata H, Shinohara T, Yamamoto M, Iwatsuki K. Simple debridement has little useful value on the clinical course of recalcitrant ulnar wrist pain. https://www.ncbi.nlm.nih.gov/pubmed/8902134, (4) Osterman AL. TFCC tear causes, symptoms, and treatment. can tfcc tear heal without surgery . Clin Orthop Relat Res. https://www.ncbi.nlm.nih.gov/pubmed/2363779, (5) Cooney WP, Linscheid RL, Dobyns JH. Meaning we have no gold standard research that shows us that either TFCC surgery is better than doing nothing. Classification of ulnar triangular fibrocartilage complex tears. I never got surgery, why? A case study from 2016 suggests that TFCC tears that do not require surgery can take up to 12 weeks to fully heal. Following surgery, an ace wrap and dressing is applied; removed at 1 week and range of motion is encouraged to heal. Methods: This paper is a case study of a subject with a magnetic resonance imaging-confirmed TFCC tear. (3) In addition, some surgeons try to shorten the ulna bone, but the research shows that this is likely not needed (9). In the more severe cases, surgery is an option to re-stabilize the TFCC and the wrist joint. Ste 105 Meaning, my recovery period, apart from a few days of wrist aching, was vastly quicker than if I had chosen surgery. An injury or tear to the TFCC can cause chronic wrist pain. Conservative treatment is thought be ineffective for chronic TFCC lesions or tears, meaning that the tear or injury … Through another small incision, instruments are inserted for either repair or trimming away of the torn portion of the TFCC. Surgery may consist of the debridement (removal) of damaged tissue and tears of the articular disc or meniscal homologue that may be catching on other joint surfaces. D. Edges of the TFCC tear have been trimmed to a stable rim, the torn fragments are removed. This more extensive surgery requires an open incision. 2018 Nov;34(11):2994-2998. doi: 10.1016/j.arthro.2018.05.044. The Atzei classification of type 1b TFCC tears is described in Table 84.1. We have been using the Percutaneous TFCC Ligamentoplasty procedure for many years to help reduce recovery and eliminate the need for surgery in patients with TFCC tears with and without instability. The TFCC, or Triangular FibroCartilage Complex, is a soft tissue cushion and wrist stabilizer on the ulnar side (pinky finger side) or the wrist. 2018;5(1):6. The TFCC stabilizes the two forearm bones together – the radius and ulna. This MRI arthrogram shows a tear in the TFCC, allowing the dye (white fluid on MRI) to leak out of the joint. About 30% of TFCC tears will heal on their own by about 6-months. Wrist arthroscopy - some TFCC tears can be treated with a minimally invasive procedure performed through small incisions on the back of the wrist. As an alternative to surgery, he consented to wear a novel brace for 12 weeks after conservative management of his injury had failed. by Chris Centeno | Oct 23, 2019 | Stem Cell Blog. An MRI is performed and shows a triangular fibrocartilage complex (TFCC) injury. Pain along ulnar (pinky finger) side of the wrist, Discomfort with wrist motion – most commonly rotating the wrist/forearm and bending the wrist towards the pinky finger. As far as repair versus debridement, one is unlikely to better than the other and neither have any high-level research to support that they work well versus a sham procedure (10). Patients without at least 3 months of documented postoperative follow up were excluded.