TFCC tear & distal ulna impingement
What is TFCC tear & distal ulna impingement?
The triangular fibrocartilage complex (TFCC) stabilises the ulnar side of the wrist and the distal radioulnar joint. TFCC tears and distal ulna impingement can cause ulnar-sided wrist pain, especially when the ulna is relatively long or after injury.
Common symptoms
Patients describe pain on the little-finger side of the wrist, clicking, weakness with grip, pain with rotation, difficulty doing push-ups and discomfort when loading the wrist in extension or ulnar deviation.
Diagnosis and imaging
Examination assesses TFCC tenderness, distal radioulnar joint stability, forearm rotation and ulnar impaction signs. X-rays assess ulnar variance. MRI or MR arthrogram can show TFCC injury, while CT may be used to assess joint alignment and rotational issues.
Non-surgical treatment
Treatment may include splinting, hand therapy, load modification, anti-inflammatory medication and corticosteroid injection. Acute stable injuries can sometimes heal with protection and careful rehabilitation.
Surgical treatment
Surgery depends on the tear pattern and bony anatomy. Options include wrist arthroscopy with TFCC debridement or repair, ulnar shortening osteotomy, wafer procedure or stabilisation of the distal radioulnar joint where required.
Recovery and follow-up
After TFCC repair or ulnar shortening, the wrist and forearm are protected initially, then rotation and strengthening are restored gradually. Return to heavy gripping or sport is staged over months.
TFCC tear & distal ulna impingement FAQs
Why does the little-finger side of my wrist hurt?
Ulnar-sided wrist pain can come from the TFCC, distal radioulnar joint, tendons or ulnar impaction. Careful examination and imaging help identify the main source.
How is tfcc tear & distal ulna impingement diagnosed?
Diagnosis starts with a focused history and examination, then uses imaging selectively to confirm the pattern of injury, exclude related problems and plan treatment accurately.
What is a long ulna?
A relatively long ulna increases load through the ulnar side of the wrist. In some patients this contributes to TFCC wear and impaction pain.
Will I need surgery for tfcc tear & distal ulna impingement?
Many patients improve without surgery. Surgery is considered when symptoms remain limiting despite appropriate non-surgical care, when there is significant structural damage, or when delay may compromise function.
When can I return to golf, tennis or gym loading?
Return depends on the diagnosis, treatment type, tissue healing and the physical demands of the activity. The plan is usually staged, with strength, range of motion and confidence rebuilt before unrestricted loading.
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