The Triangular Fibrocartilage Complex (TFCC) is a network of ligaments and cartilage on the pinky-finger side of the wrist. It functions as a shock absorber and stabilizer where the radius and ulna meet. Surgery is necessary when a TFCC tear causes persistent pain, instability, or a clicking sensation that conservative treatments fail to resolve. The procedure aims to repair torn tissue or remove damaged portions, restoring the wrist’s stability and function.
Immediate Post-Surgery Care
The initial phase after surgery focuses on managing discomfort and protecting the repair site. Pain management begins immediately, often utilizing a nerve block administered during the procedure, which provides relief for 4 to 12 hours. Prescribed pain medication manages expected discomfort once the block wears off, typically most pronounced in the first 48 to 72 hours.
The wrist will be placed in a splint or cast designed to immobilize the joint and protect the repair for the first two to six weeks. Keep this device clean and completely dry, especially when showering, to prevent complications. To control swelling, elevate the hand and wrist above the level of the heart during the first few days.
Wound care involves monitoring the surgical site, which may have small incisions from an arthroscopic procedure. Move your fingers and elbow frequently to prevent stiffness and maintain circulation while the wrist remains immobilized. Initial follow-up usually occurs within the first two weeks, where sutures may be removed and the splint potentially replaced.
The Physical Therapy Process
Physical therapy (PT) typically begins once the initial period of strict immobilization ends, usually two to six weeks post-surgery. The precise start time depends on the surgical technique; simple debridement allows for earlier motion than a complex repair. The goals of therapy are to restore full, pain-free range of motion, increase muscle strength, and regain wrist stability.
Early-stage PT focuses on gentle, passive range-of-motion exercises, where the therapist assists movement to prevent stiffness without stressing healing tissue. You will also perform exercises for the shoulder and elbow to avoid stiffness in those joints. The focus then transitions to active range-of-motion exercises, where you independently move the wrist through its available range.
As healing progresses, usually around six to eight weeks, the program incorporates light strengthening exercises. These begin with gentle isometric exercises and gradually advance to dynamic resistance exercises. The therapist uses specific techniques to restore movements lost due to injury or immobilization, such as ulnar deviation and forearm rotation. Consistent adherence to prescribed exercises is necessary to maximize the surgical outcome.
Expected Timeline for Activity Resumption
The timeline for returning to daily activities varies based on the surgery type and individual healing rate. For sedentary or desk-based work involving minimal wrist strain, return is often possible within two weeks, once immediate post-operative pain subsides. Weight-bearing activities on the operative wrist are restricted to under two pounds for the first four to six weeks.
Driving is restricted until the surgeon confirms sufficient, pain-free range of motion and cessation of narcotic pain medication. This milestone can be reached as early as two weeks after a minimally invasive procedure, but may take up to two months following a complex repair requiring longer immobilization. Returning to manual labor, which involves repetitive motion or heavy lifting, often requires clearance around six weeks or longer depending on job duties.
A full return to demanding activities like heavy weightlifting or contact sports is usually delayed for at least three to six months. Strength and stability must be fully restored before placing high-impact stress on the repaired TFCC. Overall recovery, including full strength, can take up to six months, with studies showing 84% of patients successfully return to their previous work or sport activities.
Signs of Concern During Recovery
While pain and swelling are expected after surgery, certain symptoms warrant immediate contact with your medical team. Signs of infection include a fever higher than 100.4°F or chills, excessive redness around the incision sites that is spreading, or the presence of yellow or pus-like drainage. A sudden, disproportionate increase in pain that is not relieved by the prescribed medication is also a cause for concern.
Monitoring circulation and nerve function in your hand and fingers is important. Seek medical attention if you experience severe, persistent numbness or tingling in the fingers, particularly the ring and little fingers, which could indicate irritation or injury to the ulnar nerve. Loss of circulation, indicated by a pale or blue color in the fingers that does not return to normal, is an immediate emergency. Significant loss of the ability to move the fingers, shoulder, or elbow should be reported promptly to your physical therapist or surgeon.