Arthroscopy with TFCC Repair

The triangular fibrocartilage complex (TFCC) is a structure made of cartilage and ligaments in the wrist, located on the side of the small finger.  The TFCC supports and stabilizes the forearm and wrist, especially during rotation or load bearing.  Injury to the TFCC can be a result of trauma, such as falling onto an outstretched hand or excessive rotation of the wrist, but can also be caused by chronic degeneration.  Injury to the TFCC most commonly results in pain to the small finger side of the wrist.  Moving your wrist from side to side, rotating your forearm, or gripping objects can exacerbate pain.   Other common symptoms include swelling, decreased grip strength, or grinding/clicking when moving the wrist.

Arthroscopy is a minimally invasive procedure in which a camera is inserted directly into a joint space through a small incision.  This camera allows for direct visualization of the contents in a joint, in this case, to examine the nature and extent of damage to the TFCC.  Once visualized, repair can be conducted by inserting surgical instruments through another small incision into the joint space.  Depending on the extent of damage to the TFCC, arthroscopic repair can range from removing damaged tissue and cleaning the joint space to repairing ligaments with sutures.

Arthroscopy with TFCC repair is done on an outpatient basis, meaning you will be able to go home the same day of the surgery.  You will be discharged in a temporary splint that must be kept clean and dry until you are seen for follow up with your surgeon.  It is important to elevate your arm on a couple of pillows to alleviate pain and swelling.  You will follow up with us in the office 1-2 days after the procedure.  We will write you a prescription for an ulnar gutter splint that can be removed to shower.  You are able to shower 48 hours after surgery, however, it is important that you do not submerge your surgical incision in water (i.e. no bath tubs, swimming pools, washing dishes, etc.).  You will need to wear the splint at all times except when showering. While showering, it is important you do not use your hand/arm. After showering, pat incision dry and replace splint.

Sutures will be removed 10-14 days after the procedure.  Follow up appointments are typically scheduled at two week intervals after surgery so we can monitor your recovery.  Occupational therapy can begin 6 weeks after surgery.  The splint will gradually be discontinued in the weeks to follow as you progress with occupational therapy.  Your lifting restrictions will gradually be increased over the next 2-3 months, as indicated by your healthcare provider.

It is a good idea to start with things like toast, Jell-O, crackers, and soup to see how your stomach tolerates food after anesthesia.  Drink plenty of fluids such as water or Gatorade and limit your intake of sodas, coffee and other caffeinated beverages.

We will send you home with a prescription for an antibiotic and a pain medication.  It is important to take your antibiotic and pain medication with food to prevent nausea (unless you are instructed otherwise).  Do not take your pain medication and antibiotic at the same time as this may upset your stomach; separate them by an hour or two.  You cannot drive while taking pain medication or while wearing your splint.  

Should you develop any of the following signs and or symptoms of possible infection, call our office immediately:

  1. Fever over 100.3
  2. Chills or night sweats
  3. Unusual swelling, redness, or warmth to your incision site
  4. Purulent drainage from incision site.

Please do not hesitate to call our office with any concerns or questions you may have.

Please remember the above instructions are only a guide.  Always listen to the instructions given by your healthcare provider and follow those if in conflict with any listed above.

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