What is a TFCC tear, and how is it treated?

In short

A TFCC tear is a tear in the triangular fibrocartilage complex, the small cushion and ligaments on the little-finger side of the wrist. Treatment starts with rest, a splint and anti-inflammatory medication, then a cortisone injection, and arthroscopic surgery to trim or repair the cartilage only if those fail.

Written for patients by The Hand and Wrist Institute. Prepared for review by John T. Knight, MD. Last updated September 5, 2026How we write and review

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What a TFCC tear is

Put a fingertip on the little-finger side of your wrist, just past the crease, and press into the soft spot below the knob of bone. Under there sits a small triangle of cartilage ringed by ligaments, the triangular fibrocartilage complex, or what we call the TFCC. It cushions the end of the forearm bone against the small bones of the wrist and holds the two forearm bones together where they meet, so it carries load every time you turn your palm up and down.² It works the way a washer does under a bolt, spreading load and keeping two hard surfaces from grinding.

A tear usually comes from a twist rather than one dramatic injury: free weights lifted with the wrist torqued, a torque gun run against resistance, luggage pulled off a moving belt, or a fall onto an outstretched hand. Where the tear sits changes what follows, because a split through the middle has poor circulation and little healing potential, while a tear at the outer edge has circulation and holds the two forearm bones steady.¹

Is this a TFCC tear or a wrist sprain?

Check where the pain sits and what sets it off. TFCC pain sits on the little-finger side rather than the thumb side, and it flares when you rotate the forearm rather than when you only bend the wrist, so turning a doorknob, twisting a jar lid or pushing up out of a chair will reproduce it. A wrist sprain more often follows one fall, spreads across a broader area, and eases week by week without a catch in it.

So neither of those is a diagnosis. The exam settles which side hurts and which movement brings it on, and an MRI arthrogram, an MRI done with contrast dye placed into the joint, shows whether the cartilage is torn.¹

How a TFCC tear is treated

The order runs the way it does for most wrist problems here, which puts surgery at the end and not at the start.

1. Change what is loading the wrist. Stop the lifting, twisting or racket work that reproduces the pain.
2. Splint the wrist and take an anti-inflammatory such as ibuprofen for about four weeks. A partial tear often settles here.
3. If symptoms have run on for months, a splint still reduces them, and a cortisone injection can be added.
4. If a complete tear does not settle, surgery is done through two incisions about two millimeters wide on the back of the wrist, a camera in one and instruments in the other.¹
5. A tear through the middle is trimmed into an oval so the edges can no longer meet as the forearm rotates. A tear at the edge is stitched back down, because it can heal and because it keeps the forearm bones stable.

Recovery after a trim is short and recovery after a repair is long, because a repair has to be protected while it heals. Dr. Knight states both timelines below.

When to call us

• Pain on the little-finger side of the wrist that has not eased after a few weeks of rest and a splint
• A click, catch or clunk you feel when you turn your palm up and down
• A wrist that gives way when you push up out of a chair or lift a full pan
• Grip that has dropped enough to change how you work
• Swelling and pain on that side after a fall onto an outstretched hand