IS case 493: Triangular fibrocartilage tear

Scott Wilbur, MD

University of Rochester

Imaging Sciences URMC 2010
Publication Date: 2010-08-30


Patient is a 23-year-old female with right wrist pain and swelling.


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Triangular fibrocartilage tear


The triangular fibrocartilage complex (TFCC) is a group of ligaments that supports and connects the distal radius and ulnar carpus to the distal ulna. The distal insertion points on the carpal bones are the lunate and the triquetrum. The insertion on the ulna extends to the ulnar styloid. The TFCC's function is to allow for stable rotational movements of the radiocarpal unit around the ulnar axis.

The most common mechanism for injury to the TFCC is a fall on the outstretched and pronated wrist. Other mechanisms include power drill use in which the drill forcefully rotates the wrist, distraction forces applied to the forearm or wrist, and fractures of the distal radius. There is no association between fractures of the ulnar styloid and injuries to the TFCC. There is, however, an association between TFCC tears and positive ulnar variance.

Patients with TFCC injuries typically present with symptoms of ulnar-sided wrist pain, often associated with clicking, a history of fall or trauma, and symptoms that worsen with activity and are relieved by rest. Treatment of TFCC tears is either medical, consisting of 8-12 weeks of conservative therapy or immobilization with a splint or cast, or surgical treatment by arthroscopic shaving or fixation.


  1. Verheyden JR, Palmer AK. Triangular fibrocartilage complex injuries. eMedicine. June 23, 2009.

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