Clicking on the little-finger side of the wrist - TFCC Tear

A clicking or catching sensation on the little-finger side of your wrist, especially when you twist a door handle, pour a kettle, or push up from a chair, can be an early sign of a TFCC tear.

What is the TFCC/Triangular Fibrocartilage Complex?

The Triangular Fibrocartilage Complex (TFCC) is a structure located in the wrist, specifically on the ulnar side (the side of the little finger). It consists of several components that play a crucial role in wrist stability and function.

Components of the TFCC

• Triangular Fibrocartilage: A fibrocartilaginous disc that acts as a cushion between the end of the ulna bone and the carpal bones.

• Ulnar Collateral Ligament: Provides stability to the ulnar side of the wrist.

• Palmar and Dorsal Radioulnar Ligaments: Connect the radius and ulna, providing support during forearm rotation.

• Meniscus Homologue: A small structure that aids in load distribution and joint stability.

Functions of the TFCC

• Shock Absorption: Helps absorb forces transmitted through the wrist during activities.

• Joint Stability: Stabilizes the wrist joint, particularly during rotation and gripping activities.

• Load Distribution: Distributes loads across the wrist, reducing stress on individual bones and cartilage.

Clinical Significance

The TFCC can be injured due to trauma or repetitive stress, leading to symptoms such as pain on the ulnar side of the wrist, swelling, and decreased range of motion. Proper diagnosis and treatment are essential for recovery and maintaining wrist function.

The TFCC, or triangular fibrocartilage complex, is a small cushion of cartilage and ligaments that sits on the little-finger side of the wrist. It supports the joint between the two forearm bones and helps the wrist rotate and bear weight smoothly. When part of this cushion tears, it can no longer glide as it should, which is what causes the clicking, catching, or a dull ache during twisting movements.

Why does it happen?

TFCC tears usually happen in one of two ways. A sudden injury, such as falling onto an outstretched hand or forcefully twisting the wrist during sport, can tear the tissue in an otherwise healthy wrist. More commonly, the cartilage simply wears thin over years of use, particularly in people whose forearm bones are slightly mismatched in length, a pattern that becomes more likely with age. Repetitive twisting activities, whether at work or in racquet sports, can also contribute.

When should I see a hand surgeon?

It is worth arranging an assessment if the clicking is accompanied by ongoing pain, if your grip feels noticeably weaker, or if the wrist feels unstable or gives way. Symptoms that persist for more than a few weeks despite rest, or that follow a specific fall or twisting injury, should also be checked. Left unassessed, some tears can affect the wrist joint over time, so earlier review is generally preferable.

How is it treated?

Many TFCC tears settle with non-surgical care, including a period of splinting to rest the joint, activity modification, and guided physiotherapy to restore strength and movement. Where symptoms persist despite these measures, or where the tear is more significant, injections and keyhole surgery to repair or trim the damaged tissue can be effective. A surgeon will recommend the right course based on the pattern of the tear and how it responds to initial treatment.

If wrist clicking or pain is troubling you, book a consultation at londonhandandwristsurgeon.com for an individual assessment.