TFCC lesions can be classified according to the cause and extent of the damage:

1. Traumatic TFCC lesion:
   • Acute injury due to external influences such as falls or sudden rotational movements.
2. Degenerative TFCC lesion:
   • Damage due to wear and tear, often caused by age-related wear or chronic overuse.
3. Complex TFCC lesion:
   • Combination of traumatic and degenerative damage with additional accompanying injuries.

The causes of TFCC disc injury are varied and include:

• Traumatic events:
  • A fall on the outstretched hand is a common cause of TFCC lesions.
  • Sudden, forceful twisting movements of the wrist, as seen in sports or accidents, can damage the TFCC.
• Degenerative changes:
  • With increasing age, the load-bearing capacity of the TFCC decreases, increasing the likelihood of damage.
  • Chronic overuse from repeated movements or stresses, such as in tennis or working with heavy tools.
• Anatomical factors:
  • An elongated ulna (ulna-plus variant) leads to increased stress on the TFCC, resulting in wear and tear.
• Inflammatory diseases:
  • Rheumatoid arthritis or other inflammatory diseases can weaken the TFCC and make it more susceptible to injury.

The symptoms of a TFCC disc injury vary depending on the severity and cause, but often include:

- **Pain:**

- Localized pain on the little finger side (ulnar side) of the wrist, intensified during rotational movements or stress.

- **Swelling:**

- Visible or palpable swelling in the wrist area.

- **Clicking or snapping noises:**

- An audible or palpable clicking when moving the wrist.

- **Feeling of instability:**

- The sensation that the wrist is "giving way" or is unstable.

- **Movement restrictions:**

- Difficulties with rotational movements such as turning a key or opening a jar.

The diagnosis is made through a combination of medical history, clinical examination, and imaging techniques:

- Medical history:

- The doctor inquires about the course of the symptoms, possible causes of injury, and stress patterns of the wrist.

- Clinical examination:

- Special tests such as the grip strength test or the press test help identify pain and instability in the TFCC area.

- Imaging techniques:

- MRI: High-resolution imaging of soft tissue damage such as tears in the TFCC.

- Arthroscopy: Diagnostic and therapeutic method for direct viewing of joint structures.

Conservative Therapy

In many cases, a TFCC disc injury can be treated without surgery:

• Immobilization:
  • Use of wrist splints or orthoses to relieve the TFCC.
• Physiotherapy:
  • Exercises to strengthen the surrounding muscles and improve stability.
• Pain therapy:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to reduce pain and inflammation.
• Injection therapy:
  • Injections of cortisone or hyaluronic acid to relieve inflammation.

Surgical Therapy

If conservative measures are not sufficient or in cases of severe damage, surgery may be necessary:

• Arthroscopic repair:
  • Minimally invasive techniques for suturing or removing damaged TFCC parts.
• Open surgery:
  • Required in rare cases of complex damage, e.g., with an ulna-plus variant.
• Reconstruction:
  • Replacement of the damaged TFCC with tissue from other body areas.

To prevent TFCC disc injuries, the following measures are recommended:

1. Ergonomic work: Avoiding unilateral strain or repetitive rotational movements.
2. Proper technique in sports: Using protective measures and training correct movement patterns.
3. Strengthening wrist muscles: Regular exercises to improve stability.
4. Avoiding overstrain: Taking breaks during intense activities or wrist strain.
5. Early treatment: Immediate clarification at the first signs of pain or instability.