Dr. Jonathan Mulford, Orthopaedic Surgeon, NSW Australia Total Knee Replacement, NSW Australia
Sports Knee Ligament Reconstruction, NSW Australia
Knee Arthroscopy, NSW Australia

T.F.C.C. Tears

Reproduced with permission from Dr Stuart Myers at www.myhand.com.au


Anterior Cruciate Ligament Injury, NSW Australia

The Triangular Fibrocartilage (T.F.C.) is a strong ligament type structure in the wrist. It acts to stabilise the joint between the Radius and Ulna. It also acts as a spacer between the Ulna head and the wrist joint. It may cause pain when torn or can result in clicking or catching in the wrist.

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It has a poor blood supply and it derives its nutrition largely from the fluid in the wrist joint. The edge of the TFC has a better blood supply ( Peripheral 10-15%). The lack of blood supply has implication for healing similar to the menisci in the knee. (“Cartilages in the knee”). A central tear does not heal when torn but a peripheral tear may heal. Many people have degenerative tears of the central portion of the TFC as they get older and yet may have no pain at all.

Ulna Length ( Ulna Variance)

On a front view of the wrist the radius and ulna are approximately the same length.

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With normal gripping and leaning on the hand 80% of the force passes from the wrist bones to the radius & 20% to the ulna. Minor changes in length of the ulna variance have profound implications for these forces. Approx 2mm change in length has a 20% effect on the forces.

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A long ulna can cause:

  • Tear of the TFC
  • Arthritis on the Lunate, Triquetrum
  • Tear of the L-T ligament

Uniarthroplast, NSW Australia


  • Central or Peripheral tear
  • Trauma or Degenerative
  • Other injuries eg fracture, nerve, ligaments
  • Age, Activity Level, General Health
  • Non - Dominant Hand
  • Risks of Surgery

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  1. Activity modification
  2. Anti-inflammatory tablets
  3. Cast
  4. Splint


  1. Arthroscopy

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  1. Trim the torn cartilage

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  2. Repair
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2. Arthroscopy & Ulna shortening

3. Plate removal – required in 2/3rds of cases

Ulna shortening:

  • If the ulna is too long
  • The bone is cut using a saw and a plate is applied to the bone with 6 - 7 screws
  • Overnight stay in hospital
  • Plaster for 6 – 8 weeks or until bone cut has healed
  • Activity restriction for 3 + months
Knee Replacement Surgery, NSW Australia
Sydney Orthopaedic Surgeon, NSW Australia

I am a orthopaedic surgeon that specialises in all aspects of Hip and Knee surgery...

Meet Dr. Jonathan Mulford
Trauma Surgery, NSW Australia
Dr Mulford was awarded a Diploma in Clinical Trials from the University of London in 2008.
Clinical Research
Location Maps Acute Knee Injury Clinic
Revision Knee Replacement, NSW Australia  
Wrist Arthroscopy, NSW Australia
Tamar Valley Orthopaedics
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