TFCC Compression Test | Triangular Fibrocartilage Complex Assessment

The triangular fibrocartilage complex, abbreviated as TFCC consists of the articular disc, the meniscus homologue, the dorsal and palmar radioulnar ligaments, the ulnolunate and ulnotriquetral ligaments, and the extensor carpi ulnaris tendon sheath.

As a center of forearm rotation, the TFCC plays a key role in stabilization, rotation, translation, loading transmission to the wrist and acts as an essential pivot point. Due to its anatomical location as well as its involvement in the key functions of rotation and load-bearing, it is highly prone to injuries and attritional wear.

Unfortunately, no statistical values are described for this test, which is why we assign this test a questionable clinical value.

To perform the TFCC Compression Test according to Prosser et al. in the year 2011, fixate your patient’s radius and ulna with one hand close to the joint line. Then grab your patient’s hand at the height of the meta-carpals from radial and bring his wrist into ulnar deviation under axial compression.

This test is positive for a TFCC tear in case your patient’s pain is reproduced with a click or crepitations.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Other orthopedic tests to assess the triangular fibrocartilage complex are:

• Fovea Sign
• Ulnar Grinding Test

Other common tests for injuries at the wrist are:

• Watson / Scaphoid Shift Test for Scapholunate Instability
• Distal Radioulnar Joint / DRUJ Test
• Lunotriquetal Ballottement / Shuck Test 

Prosser R, Harvey L, LaStayo P, Hargreaves I, Scougall P, Herbert RD. Provocative wrist tests and MRI are of limited diagnostic value for suspected wrist ligament injuries: a cross-sectional study. Journal of physiotherapy. 2011 Jan 1;57(4):247-53.