03 / WRIST
Wrist Arthroscopy, TFCC & Ligament Surgery
Small structures have a large role in wrist stability. Arthroscopy can help assess the joint and, in selected cases, treat a confirmed problem. A repair or reconstruction needs a different recovery plan from a diagnostic examination.
Understand the pathway01 / WHAT THIS TREATMENT ADDRESSES
Understand what can change.
Arthroscopy & TFCC treatment
A small camera allows the surgeon to inspect cartilage and supporting tissues. Selected TFCC tears may be trimmed or repaired, depending on their location, tissue quality and effect on stability.
Ligament repair or reconstruction
An injured scapholunate ligament can allow wrist bones to move abnormally. A recent repairable injury and an established unstable wrist may require different approaches. Some problems need open surgery.
02 / WHEN TREATMENT IS CONSIDERED
A reason to intervene.
A reason to be careful.
Symptoms, examination and imaging must fit together. Rest, splinting and rehabilitation may be appropriate for stable injuries. Persistent mechanical pain or a significant unstable injury may justify surgery. An MRI finding alone does not determine the treatment, and arthroscopy is not necessary for every painful wrist.
03 / BEFORE THE PROCEDURE
A clear plan before the day.
Bring previous imaging and describe the original injury, clicking, loading pain and work or sport demands. X-rays, stress views or MRI may help planning. Discuss what will happen if arthroscopy finds a different problem, and whether repair would need a longer period of protection.
Bring your questions.
Review medicines, allergies and health conditions with the team. Follow your own instructions about fasting and medication changes; do not stop prescribed treatment on your own.
Ask what help, transport and time away from work you may need.
04 / THE PROCEDURE
A PATIENT GUIDE / THREE KEY STAGESPrecision in every step.
The TFCC lies on the ulnar side of the wrist between the distal ulna and the ulnar carpus, supporting distal radioulnar stability. Arthroscopy uses small dorsal portals to inspect the joint. The portal marker is a conceptual surface entry, not a surgical landmark or instrument trajectory.
- Radius
- Ulna
- Carpal bones
- TFCC on the ulnar side
- Dorsal portal concept
The scapholunate ligament joins the scaphoid and lunate in the proximal carpal row. It helps keep the bones moving together. Selected repair or reconstruction aims to restore stability and alignment; the drawing does not prescribe a surgical technique.
- Scaphoid
- Lunate
- Scapholunate ligament
- Radius / wrist alignment
See
A camera enters the wrist through small access points to inspect relevant joint surfaces and supporting structures.
Treat
A selected problem may be trimmed, repaired or stabilised. A ligament reconstruction may require an open approach and additional protection.
Support
The access points or incision are closed. A dressing, splint or cast protects the wrist according to what was treated.
05 / ANAESTHESIA & THE DAY
The plan is personal.
Regional anaesthesia, sometimes with sedation, or general anaesthesia may be used. Many wrist arthroscopies are day procedures; a more involved reconstruction or individual health needs can change the plan. The surgeon explains the findings and any changes to rehabilitation.
06 / RECOVERY
PROTECT → MOVE → STRENGTHENProgress has
its own pace.
These are guideposts, not personal clearance dates. Your operation, healing and clinical review determine the next step.
Arthroscopy / trimming
First 2–3 days
Swelling & dressing care
Elevate as advised and keep the dressing clean and dry.
Early follow-up
Review the findings
The treatment performed determines how soon wrist movement and everyday use progress.
Following weeks
Graded rehabilitation
Rebuild comfortable movement and loading under the agreed plan.
After functional review
Return to sport
Pain, strength, stability and the demands of the sport matter more than incision size.
TFCC / ligament repair
Immediately
Protect the repair
A cast or splint may restrict wrist or forearm movement.
Several weeks
Biological healing
Protection is generally longer than after trimming alone. The exact duration depends on the repair and any fixation.
After protection
Restore motion
Therapy progresses gradually; stiffness after immobilisation is expected.
Following months
Strength & stability
Heavier work and sport follow a staged assessment. Some reduction in motion or strength can remain.
07 / RETURN TO LIFE
Back to the things
that matter.
- Work
- One-handed or modified duties may be needed while a repair is protected. Manual and weight-bearing work usually require a later review.
- Driving
- A cast, restricted rotation or weak grip can make driving unsafe. Wait for adequate control and confirmation from your clinical team.
- Sport & therapy
- Press-ups, racquet sports and heavy lifting stress healing structures. A therapist can guide a staged return after the surgeon clears loading.
08 / RISKS & CONSIDERATIONS
A balanced
decision.
Possible risks include infection, bleeding, nerve or tendon injury, stiffness, persistent pain and failure of a repair to heal. Instability can recur and further surgery may be necessary. Established cartilage damage can limit what ligament treatment achieves.
09 / THE GOAL
Useful function.
Realistic expectations.
Treatment aims to improve comfort and stability while preserving useful movement. The result depends on the injury’s age, healing potential, cartilage condition and rehabilitation. Restoring every aspect of a previously uninjured wrist is not always possible.
10 / YOUR QUESTIONS
Before you decide.
Can everything be repaired through a camera?
No. Some lesions can be treated arthroscopically, while others need open repair, reconstruction or a different strategy.
Why can a small incision need a long recovery?
Skin healing is only one part of recovery. Ligaments and the TFCC may need prolonged protection before they can tolerate load.
Will I need temporary wires?
Some stabilisation procedures use temporary fixation. If planned, the surgeon explains protection, follow-up and removal. It is not required for every arthroscopy.
CLINICAL READING
Sources & further reading.
General patient guidance to support a consultation. Your own surgical plan and discharge instructions take priority.
- AAOS · Wrist arthroscopy
- Gloucestershire Hospitals · TFCC injuries
- Gloucestershire Hospitals · Scapholunate injuries
- NHS Bexley · Scapholunate instability
- AAOS · Wrist sprains
- Anatomy reference · Wrist arthroscopy / TFCC
- Anatomy reference · Scapholunate ligament surgery
- Royal College of Anaesthetists · Preparing for surgery
- Chelsea and Westminster Hospital · Before hand surgery
A CONSIDERED NEXT STEP
The right treatment starts
with the right diagnosis.
Understand your options, discuss the trade-offs and plan a recovery that fits your life.
PROF. DR. SAMI HASSAN / HEALTHPOINT