TFCC (triangular fibrocartilagenous complex) repair

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You have just undergone a repair of the TFCC. This is an important ligamentous complex in your wrist which is vital for stability of the joint between the radius and ulna. In the majority of times, this procedure would have been performed arthroscopically by Kemble, although occasionally an open repair is required. 

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The following is a schematic diagram of such a repair, as well as intraoperative photos from one of Kemble's previous operations. 

• Postoperatively your arm will be in a splint that goes all the way from the wrist to almost up to the shoulder. Your arm will also be in a sling

• It is normal to have some tingling or numbness or weakness following your procedure. This is often due injected local anaesthesia. This will wear off in the first day or two.

• Please keep your dressing/bandage dry at all times. You may use a plastic bag tied above the elbow to prevent the dressing/wound from getting wet during shower/bathing

• Around 2 weeks following surgery, you should have your wound checked. The sutures are usually all dissolvable

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Therapy and movement

 

0-2 weeks

• Finger movements - into a fist and spread all the way  ​

• Stay in above elbow backslab full time

• Sling full time except for sleep

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2-6 weeks

• Into Munster splint. 

• start all active/passive elbow flexion/extension

• No forearm rotation

• Can come out of Munster for gentle wrist flexion/extension (40 to 40). No dart throwers, no radial or ulnar deviation

• Stay in Munster all times except during exercises

 

6-12 weeks

• Out of Munster, commence all active and passive ROM

• Once 80% of ROM achieved, commence gradual loading of wrist - start at 5kg, then 10kg, then 15kg and progressive if tolerated. 

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12 weeks +

• No restrictions