Which physical findings are characteristic of TFCC tears in patients with ulnar-sided wrist pain?

Updated: Apr 26, 2021
  • Author: David M Lichtman, MD; Chief Editor: Harris Gellman, MD  more...
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The TFCC is palpated just distal to the ulnar head. Any tenderness may indicate TFCC tears or chondromalacia from an acute injury or ulnar carpal abutment. Each of these disorders may be associated with clicking. Acute tears result in tenderness over the radial attachment (Palmer type ID injury) or avulsions off of the ulnar styloid (Palmer type IB injury).

The TFCC load test may reveal TFCC tears, though the pain may arise from ulnar abutment or chondromalacia of the hamate. To perform this test, apply axial force along the patient's ulnarly deviated wrist. With TFCC tears, forearm pronation and supination are usually pain free (unless passive rotation is initiated at the wrist or hand level). Dorsal subluxation or dislocation of the ulna results in decreased supination and a prominent dorsal ulnar head in pronation. Volar subluxation or dislocation results in decreased pronation and a dimpling of the dorsal skin over the ulnar head in supination.

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