The treatment options
Conservative treatment of the TFCC lesion usually consists of immobilising the wrist first with a splint and later with an orthosis. This allows the TFCC to regenerate and small defects can be repaired by the body. At the same time, cautious physiotherapy should be started so that immobilization does not cause any later restrictions of movement.
Conservative treatment is particularly suitable for small defects where the TFCC has sufficient blood supply. Degenerative lesions are also generally best treated conservatively. Physiotherapy can be started at the same time as conservative treatment.
Initially, the focus is on the mobility of the wrist, since this can be lost quickly by immobilization without appropriate exercises. Movement exercises should also be carried out in physiotherapy after an operation. In addition, swelling and pain can be reduced more quickly immediately after an operation by means of physiotherapy.
Later on, physiotherapy is used to build up strength in the wrist in a targeted manner. Once the TFCC lesion has healed, the wrist can be exercised normally again. Possible movement restrictions that may have remained until then can also be further treated.
An orthosis is a bandage that is used on various parts of the body, usually joints. In the case of a TFCC lesion, an orthosis on the wrist is often used. Like a splint, this can initially have fixed parts, so that movement in the wrist is restricted until the lesion has healed in TFCC. A more elastic orthosis can then support the wrist in its movements until sufficient muscle strength is built up again to perform all everyday movements and to withstand the loads.
When does one need surgery?
Surgery is increasingly used in young people with a TFCC lesion. Thus, surgery in older people with a degenerative change in TFCC is usually not effective. However, young people with acute trauma of TFCC often benefit from surgery.
Especially if there are concomitant injuries in the wrist, surgery is indicated. Another indication for surgery is a disturbed blood flow to the TFCC due to the lesion. This worsens the chances of recovery enormously, which is why sufficient blood supply to the TFCC must be restored during surgery.
The operation can often be performed arthroscopically. This means that only small skin incisions are made and open surgery is rarely necessary. The duration of the operation for a TFCC lesion is usually very short and usually only takes about 30 to 60 minutes.
This is followed by complete immobilization of the wrist for about one week. Afterwards, more movement in the wrist can be gradually allowed through specific physiotherapeutic exercises. The healing phase usually takes 8 to 12 weeks.
After that, the hand can be fully used again in everyday life. However, sports such as boxing and tennis should be avoided for about 5 months.
