Triangular Fibrocartilage Complex Injuries in Racquet Sport Players: Prevalence,Management,and Outcomes

Abstract

Background:

Triangular fibrocartilage complex (TFCC) injuries are common in athletes and may lead to substantial pain and functional limitations. This study characterizes TFCC injuries in athletes, particularly those involved in racquet sports. We also report on treatment patterns, patient outcomes, and risk factors for TFCC injury.

Methods:

Patients with soft tissue injuries of the wrist at our institution in the last 9 years were screened for diagnosis of TFCC injury associated with racquet sports. Patients were excluded if there was no record of treatment or follow-up after diagnosis. Retrospective chart review was performed to collect data on demographics, injury and treatment specifics, return to baseline activity (RTBA) time after initiating treatment, and complications.

Results:

Of 700 patients diagnosed with TFCC injury, 23.1% sustained injury during sports. Twenty-five (15.4%) were playing a racquet sport, most commonly tennis (n = 21). Five patients were excluded according to exclusion criteria. Fifty-five percent of the included patients were men, adolescents, and played their sport competitively. Seventy-five percent injured their dominant wrist, with 35% sustaining an ulnar-sided tear. Fifteen patients were treated nonoperatively through wrist immobilization and therapy. Of the 5 surgically treated patients, 4 underwent arthroscopic debridement while 1 underwent open repair. Seventeen patients (12 nonoperative and all surgical) were able to RTBA (average time: 134 days), of which only one had pain recurrence.

Conclusions:

Triangular fibrocartilage complex injuries disproportionately affect tennis players but favorably resolved from nonoperative treatment in 73.3% of cases and from surgery in all cases. Prior TFCC pathology and age above 50 were associated with no RTBA.