TFCC Tear

The triangular fibrocartilage complex (TFCC) is a structure of cartilage and ligaments on the pinky (ulnar) side of the wrist. It cushions and stabilizes the small carpal bones during gripping and rotating movements. A TFCC tear can result from trauma (falls on an outstretched hand, sudden twisting) or from degenerative wear over time, causing ulnar-sided wrist pain and instability.

TFCC injuries are common in athletes who grip and rotate—tennis players, golfers, and gymnasts—as well as anyone who falls onto an outstretched hand. At Mountain Spine & Orthopedics, our hand and wrist specialists use advanced MRI imaging and clinical examination to diagnose TFCC tears and determine the optimal treatment approach.

TFCC tear symptoms typically include:

• Pain on the pinky side of the wrist (ulnar side)
• Pain that worsens with gripping, twisting, or pushing activities
• Clicking or popping with wrist rotation
• Weakness in grip strength
• Wrist instability—feeling like the wrist will "give way"
• Swelling on the ulnar side of the wrist
• Limited wrist range of motion

Risk factors for TFCC tears include:

• Sports requiring repetitive wrist rotation and gripping (tennis, golf, gymnastics, baseball)
• Falling onto an outstretched hand
• Forceful twisting injuries to the wrist
• Ulna bone that is longer than the radius (positive ulnar variance)
• Degenerative changes with aging
• Inflammatory conditions affecting the wrist

Diagnosis of TFCC tears requires careful clinical examination. Our specialists perform the TFCC compression test (ulnar deviation and axial loading reproduces pain), the fovea sign (tenderness in the soft spot between the ulna and carpals), and assess for instability of the distal radioulnar joint (DRUJ).

MRI is the imaging study of choice to visualize TFCC tears, though some tears are best seen with MR arthrography (MRI with contrast injected into the joint). We offer complimentary MRI reviews to help diagnose your wrist condition accurately.

Non-Surgical Treatment

Many TFCC tears, especially degenerative tears, improve with conservative care:

• Rest and activity modification—avoiding painful gripping and twisting
• Wrist splinting or bracing to immobilize the wrist
• Anti-inflammatory medications
• Physical therapy to strengthen supporting muscles
• Corticosteroid injection for pain relief

Surgical Options

For tears that don't respond to conservative treatment or cause significant instability:

• Wrist arthroscopy—minimally invasive surgery to repair or debride the torn TFCC
• Repair is preferred for peripheral tears in the vascular zone, which have good healing potential
• Debridement (smoothing) is used for central tears that cannot be repaired
• Ulnar shortening osteotomy may be needed if positive ulnar variance is contributing

Pain from a TFCC tear arises from loss of the cushioning and stabilizing function of this important structure. The torn cartilage may catch or pinch with wrist movement, causing sharp pain. Instability places increased stress on surrounding structures. Pain is typically activity-related and localized to the pinky side of the wrist.

Prevention Tips

• Use proper technique in racquet sports and golf
• Strengthen forearm and wrist muscles for better support
• Wear wrist guards during activities with fall risk
• Warm up properly before athletic activities
• Seek early evaluation for persistent ulnar wrist pain

If you're experiencing pain on the pinky side of your wrist, especially with gripping or rotation, schedule a consultation with our wrist specialists. We offer same-day and next-day appointments and complimentary MRI reviews to help diagnose and treat your condition.