I injured my wrist a while back and am experiencing severe pain around the end of the ulna, close to the styloid. My doctor discovered two TFCC tears - one in the central portion that gets no blood supply and the other in the periphial that does, He performed a debridement on them, which didn't help at all. He said he could repair the tear on the outside of the TFCC that gets a blood supply. My wrist would have to be immobilized for 6 weeks for it to heal. But there's a problem. He says I have arthritis in my wrist and immobilizing it for 6 weeks would probably cause it to 'grow' and would likely cause me as much if not more pain than I'm in now. I'm unable to work now (electrical construction) and unable to do many common everyday tasks (it even hurts to just carry a plate of food). Seems I've got a catch 22 - I need the TFCC repaired to ease the pain, but doing so will cause equally painful arthritis. Are there any other options or am I SOL??
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First Helper sparkie78
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replied June 1st, 2013
Especially eHealthy
sparkie78,

You do have a bit of a conundrum. Of course, the question is, how much of your pain is coming from the TFCC tear and how much is coming from your underlying arthritis?

Usually, arthritis will "act up" some with prolong immobilization. The joint surfaces need the joint fluid circulated around to lubricate them (provide their needed nourishment), and this is done with range of motion.

If you feel that the pain is coming mostly from the TFCC, have it repaired and deal with the stiffness after the immobilization is over. But, if the pain was actually coming from the arthritis mostly, repairing the TFCC usually will not help a lot.


Sorry there is not a real good answer. You have to decide what you want to try.

Good luck.
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replied June 2nd, 2013
Repairing TFCC
The pain is located at the head of the ulna. When looking at my xrays, the wrist bones are mostly over the radius with a gap over the ulna, so I think it's the TFCC causing the pain. And for what it's worth, it really doesn't 'feel' like arthritis. Since I'm unable to work or do much of anything else with my hand, I'm leaning towards having the surgery, since I don't really have anything to lose. But that raises yet another dilemma. One of the tears is located where there is no blood supply. For all I know, that could be the one causing the most pain. I'd not be a happy camper if after the surgery I still had the same pain PLUS the pain and stiffness from increased arthritis. If I understand it correctly, that 'dead' area is a sort of pad, like the miniscus in the knee. I can see where a tear would cause aggravation and inflammation. Is there nothing that can be done with this?I realize it can't heal without a blood supply, but couldn't it be sewn or stapled or glued to close the tear and hold it together?
Geez, what a nightmare. Maybe I can opt out for a steel claw.
But hey, thank you for your response. Believe me, it helps to be able to talk it out with someone who understands whats going on.
Have a great day!!
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replied June 2nd, 2013
Especially eHealthy
sparkie78,

You are correct, in that the TFCC (triangular fibrocartilage complex) is a cartilage disc held in place over the end of the ulna by a sling of ligaments. The meniscoid disk has no blood supply (like all cartilage strucutres in the body), but where it attaches to the sling of ligaments, there is some blood vessels.

So, just like in the knee, if the tear in the disc is in the avascular portion, it is just debrided (the tear is smooth out). The same thing is done in the knee. It is very rare to be able to repair a meniscal tear. Only the tears around the periphery can be repaired, in the so called red-red zone. There is a blood supply there. So, the vast majority of meniscus tears in the knee are also debrided (the torn flap taken out and the edges smoothed down).

Thus, the TFCC disc is also debrided in its center portion. Most of the time, if this is the only problem, this will take care of the patients problem. But, it is rare that a central portion tear is not assoicated with underlying degenerative changes in the articular cartilage (the white substance that makes up the joint surfaces).


As you states, you really don't have a lot to lose. Just go into the surgery with realistic expectations.

Good luck.
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