A small meniscus located on the ulnar side of the wrist (the side opposite the thumb), the triangular fibrocartilage complex (TFCC) serves as a connective site for ligaments, as well as a cushion between the carpal wrist bones and the end of the forearm. It is damaged when a strong compression and shearing force is applied to it. Since the wrist is not a weight-bearing joint, the pain and functional discomfort are minimal.

Those at Risk
While a fall on an outstretched arm could result in such an injury, athletes involved in activities requiring a large amount of wrist motion such as swinging a baseball bat, throwing a ball or other object, as well as gymnastics and other events requiring wrists to balance weight are most at risk.

Diagnosis
Patients experiencing TFCC damage may experience discomfort on the ulnar side (little finger) of the wrist, increased pain when the hand is rotated away from the thumb and a popping sound. While a physical examination and description of the accident that resulted in the injury will indicate the possibility of TFCC damage, an MRI will confirm the diagnosis.

Treatment
Depending on the severity of the damage either conservative treatment, arthroscopy or a surgical procedure to repair a tear is recommended.

Conservative treatment consists of rest and change in activity in order to reduce stress to the affected hand. It may also include casting of the wrist and the use of non-steroidal anti-inflammatory medications (NSAIDs).

If pain persists following conservative treatment, or if there was a severe tear, wrist arthroscopy may be performed. Chronic tears may require an excision of the tear.

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