WristWidget® (Black Adjustable Wrist Brace for TFCC Tears, One Size fits most. For Left and Right Wrists, Support for Weight Bearing Strain, Exercise

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For management purposes we follow the Palmer classification. Initial treatment of all types of TFCC injury includes rest, activity modification, splint, physical therapy, and corticosteroid injections. In case of failure of conservative treatment to give relief or in tears with joint instability early surgical intervention is recommended. Choice of treatment is based on type of lesion and may include open or arthroscopic repair, arthroscopic debridement, ulnar shortening, and the Wafer procedure. Limited range of motion in supination and pronation. If TFCC injury is severe, a client may present with limited wrist flexion and extension

If you think your TFCC is torn, see a healthcare provider immediately. Other TFCC conditions can have similar symptoms. But a professional can run tests to see if you have a TFCC tear or another TFCC injury. These examinations can include the following:‌ Chronic injury can occur in baseball players as a result of the heavy load placed on the wrist during the swing. These athletes can sustain TFCC injuries even if they do not have positive ulnar variance [2] For more severe injuries, post-operative immobilisation in a Muenster cast for 4 weeks may be considered.

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Ulnar carpal impingement: Differentiate because this is commonly a result of ulnar shortening due to surgical resection from a prior injury. The extensor carpi ulnaris relies on the TFCC for movement, and thus alteration of the motion of the extensor carpi ulnaris may lead to abnormal force through the TFCC, predisposing it to injury [2] These authors have published their results of repair of radial tears. They found improvement in grip strength and range of motion of 89% and 87% that of the contralateral side, respectively. Eleven of 13 patients had complete relief of pain with all activities, whereas 2 had continued mild pain with moderate activity. Sagerman and Short 40 repaired 1D tears in a cohort of 12 patients, and at an average of 17 months reported a 67% good or excellent clinical result. An injury or tear to the TFCC can cause chronic wrist pain. Sometimes called a wrist sprain, TFCC can be very painful and cause loss of motion. With TFCC, turning your wrist, pushing open a door, and pushing up from a chair, can cause your wrist to hurt. Corticosteroid injections or platelet rich plasma therapy can also be utilized in recalcitrant cases. Physical therapy to prevent stiffness and gain range of motion is instituted once discomfort due to acute trauma or inflammation has subsided. Strengthening exesices are usually begun after 6 weeks of successful recovery.

For degenerative (type 2) TFCC tears surgery may be directed at shortening the ulna bone, if it is abnormally long, and tightening the ligaments. Shortening the ulna bone means cutting it with a saw, removing a few millimetres of bone, and then fixing the bone ends together using a plate and screws. Because the ulna bone is relatively close to the skin and often rests against surfaces (eg tables, desks, computer keyboards) it is common that the plate and screws are removed once the ulna has healed. Arthroscopic techniques to clean inside the joint and to remove a few millimetres of the tip of the ulna may also be used for type 2 TFCC tears. Radiographs: may reveal avulsion of ulnar styloid, scaphoid fracture, distal radial fracture, volar tilt of lunate or triquetrum; ulnar variance. The last proactive test is called the “pressed” test. The client sits on a chair with hands grasping the edges of chair. The client is directed to weight bear on extended wrists as they push themselves up off of the chair. If pain in ulnar region occurs, the test is considered positive. Hagert E., Proprioception of the Wrist Joint: A Review of Current Concepts and Possible Implications on the Rehabilitation of the Wrist, Journal of Hand Therapy, 2010 Jan-Mar 23, 2-16 If a healthcare professional decides that you have a TFCC tear, there are a few ways you can help it heal. To relieve your pain, you can do the following:

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Recovery after surgery varies, but typically four to six weeks should be expected for arthroscopy and approximately three months for an open approach. Patients will undergo physical therapy after the procedure. The exact time to begin physical therapy and the length of physical therapy depends on the type of surgery performed and the surgeon’s preference. [2]

The best outcomes with TFCC injuries will occur when other etiologies of ulnar-sided wrist pain are ruled out with initiation of conservative treatment. Injury: The force of falling on your hand or wrist can tear your TFCC. A fall or other injury that fractures your radius can also tear your TFCC. A sudden twist of your arm that over-rotates your wrist can also cause a TFCC tear. As in other arthroscopic procedures, infection remains a risk, which is usually prevented by a prophylactic dose of parenteral antibiotics before initiating the procedure. Isometric exercises should be included to help strengthen the area and reduce the risk of instability. [25] [26] Post-operative complications like infections, hypertrophic scar, tendon injury, nerve injury, reflex sympathetic dystrophy, and joint stiffness can occur with arthroscopic management. Another major risk is of iatrogenic instability following aggressive debridement and during wafer’s procedure.Rettig AC, Athletic Injuries of the wrist and hand, part 1: traumatic injuries of the wrist. Am J Sports Med 2003:31(6):1038-48

Wear it during sports and exercise, while you are going about your day, and even while you sleep. Adjust the pressure according to your activity and the support you need. The nylon and cotton fabric offer firm yet comfortable support. For those with a smaller wrist, the ends of the TFCC brace can be easily trimmed for a better fit. In gymnastics the TFCC can be injured through overuse injury (both support skills and hanging elements). With repetitive weight bearing (both compressive and tensile), this area can become inflamed and tendonitis/tendonosis can develop in the anchoring wrist ligaments (often misdiagnosed as a wrist sprain). [7] Laying both hands flat on a table or desk and pressing the palms of your hands down. Your ulna bone may be visible when your hands are pressed but goes away when your hands are relaxed. This can be a sign that you probably have an injured, although not torn, TFCC. The best place to palpate the TFCC is the soft spot on the volar aspect of wrist distal to ulnar head between the ulnar styloid, FCU and pisiform. Tay etal. 6 described the “ulna fovea sign” which is positive when pain is elicited on plapation of this critical area labelled as fovea. When positive, it is a reliable test to diagnose tear of the ulno-triquetral ligament tear or disruption of the foveal attachment of the TFCC. This test has high sensitivity of 95.2% and a specificity of 86.5%.The Body Helix TFCC Wrist Brace is the best brace for TFCC tear injuries. It is specific to TFCC degeneration and tears. It will not help with other wrist injuries which may require a different sleeve or wrap.