Triangular Fibrocartilage Complex – TFCC
Clearwater, Tampa, St Petersburg, Florida
The triangular fibrocartilaginous complex (TFCC) is a major stabilizer of the distal medial ulnar joint, which is the lateral aspect of the wrist connecting the radius to the carpal or wrist bones. It is composed of several soft tissues: the TFCC, the dorsal and volar medial ulnar ligaments, meniscus and ulnar collateral ligament as well as the sheet of the extensor carpi ulnaris tendon.
The triangular fibrocartilaginous complex functions as a stabilizer, absorbing axial loads on the ulnar or the medial side of the wrist. Normally, the TFCC is a soft tissue structure similar to the jaw’s temporomandibular joint. If the TFCC is torn due to repetitive traumatic injury, it is a frequent source of chronic wrist pain.
Patients often complain of pain on the ulnar or medial side of their wrist with associated tenderness and wrist pain; often a click can be heard when rotating the forearm. This can be overlooked on normal radiographic studies, but is sensitive to magnetic resonance imaging scanning (MRI). Identifying the region of the tear may affect treatment as the vascular supply of the TFCC as a periphery or outside.
The periphery, which comprises of almost 20 percent of the TFCC, is highly vascular on the ulnar side and tears that occur in this region can usually be treated quite well with conservative measures. This may include immobilization and avoidance of repetitive trauma.
The remainder of the TFCC or triangular fibrocartilaginous complex is highly avascular or lacking significant blood supply. Because of this, tears that are seen centrally and more to the radial portion of the TFCC may need to have surgical intervention.
However, an alternative treatement for TFCC would be the application of platelet-rich plasma (PRP). Platelet-rich plasma is derived from the patient’s own blood. The resulting plasma is a concentration of growth and healing factors. The TFCC, as with other highly avascular joints such as knee joints and intervertebral disc that do not heal or heal slowly due to the lack of a blood supply, can be very responsive to PRP injections. Since PRP provides the growth and healing factors necessary but which are absent in avascular structures, healing can occur. Platelet rich plasma is an effective tool, not only in the vascular portion of the TFCC, but it can also heal more rapidly the peripheral zones and in the ulnar margins, which do have a better vascular supply. This rapid response is especially important in athletic injuries when performance and downtime are critical.
If you suffer with triangular fibrocartilage complex or TFCC and your current treatment plan leaves you feeling frustrated, perhaps a fresh set of experienced eyes can change your outlook. Since 1990, Dennis M. Lox, M.D has applied his personal interests in sports medicine, cutting-edge regenerative medicine and chronic pain management to helping patients increase their quality of life. Contact us for an appointment at 727-462-5582.
Dennis M. Lox, MD, and the Florida Spine Center serve patients within the greater Tampa Bay area, including Clearwater, Tampa and St. Petersburg, as well as all of Florida and the US.
All statements, information or opinions provided by this website are provided for educational purposes only. We do not diagnose nor treat through this website or by telephone. As you consider any treatment, discuss them with your physician.
Regarding platelet-rich plasma or stem cell therapy: Neither statements nor treatments have been evaluated by the FDA. We do not claim that these treatments work for any listed or unlisted condition. Patient testimonials offer only the patient’s impression of how a therapy worked for them – individual results will vary; results are not guaranteed nor warranteed. As you consider any treatment, discuss them with your physician.