Tear of the discus triangularis
Tearing of the discus triangularis is usually the result of an accident involving the wrist. Another possibility is the degenerative alteration of the discus. In this case, excessive stress on the cartilage disc leads to weakness and consequently to tearing.
The standard examination to find a diagnosis is either the MRI as a non-invasive method or arthroscopy, in which a small camera is inserted through a few millimeters of incision in the wrist to check the condition of the disc. A distinction must be made between the severity of the tear, which also determines the treatment. In mild cases, the roughened surface of the discus triangularis is merely smoothed, whereas in small tears a part of the disc can be removed and in severe tears a suture of the cartilage disc is performed. Nowadays, therapy is almost exclusively athroscopic, i.e. only with the aid of two small instruments in the otherwise closed joint cavity and only in exceptional cases on the completely opened wrist. The anesthesia is usually local, so that the patient is conscious during the operation, but the pain sensation in the affected area is eliminated.
Lesion of the TFCC
The TFCC is the so-called triangular fibrocartilaginous complex, i.e. the triangular disc triangularis and the ligaments fixing it in the area of the wrist on the little finger side. Lesions can occur here either by abrupt force in the form of a fall, blows or support from the falling movement, or by wear and tear after prolonged incorrect loading or too long a cubit compared to the radius. The diagnosis is based on the one hand on the symptoms described above: Typical are pain in the wrist during rotary movements and on the other hand with the help of MRI examination or an athroscopy of the wrist.
The treatment of the injury depends on its severity. From treatment with analgesics for mild degenerative pain to suturing for a tear in the triangular disc or a limiting ligament, the treatment is adapted to the patient’s needs. After the operation, the joint is usually immobilized for several weeks and then slowly returned to the old stress situation in everyday life with the help of physiotherapy.