TFCC Peripheral Repair — TFCC Peripheral Tear Surgical Repair

UW Health · UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation (Dr…

Weight-Bearing

NWB surgical UE until 12 weeks

Key Restrictions

No forearm or wrist ROM weeks 0-4 (Dr. Kruse/Tofte: no wrist AROM until 6 weeks); no lifting/pushing/pulling; custom muenster orthosis; no forearm ROM weeks 0-6; no sports until 12 weeks; no resistance during forearm rotation except isometrics in neutral; avoid push-ups/chin-ups on return to gym; Dr. Kruse: no forearm AROM until 12 weeks; orthosis off for hygiene only weeks 1-4

Timeline & Phases

Phase I (7-14 days): muenster orthosis, AROM shoulder and thumb, finger tendon gliding, edema management; Phase II (3-4 weeks): muenster continues; at 4 weeks (Dr. Zachary, Israel, Salyapongse, Michelotti, Gander): gentle short-arc wrist AROM <45° with forearm in neutral/supination; Dr. Kruse/Tofte: no wrist AROM until 6 weeks; Phase III (6 weeks): progress AAROM wrist, add gentle forearm rotation supination to neutral; week 7: self-facilitated forearm rotation (supination with elbow flexed; pronation with elbow extended); Phase IV (8-10 weeks): self-ROM forearm (NO torque at wrist), PROM wrist/forearm, wean wrist orthosis; Phase V (11-12 weeks): hand strengthening in supination (rubber bands/putty), light weights for elbow/wrist; 12 weeks: discontinue orthosis (continue for heavy activities)

Notes

UW Health / UnityPoint Health - Meriter Rehabilitation; OT-based; surgeon-specific variations within one protocol — Dr. Kruse most conservative; peripheral TFCC is vascular, repaired open or arthroscopically; K-wires or suture anchors stabilize forearm in neutral post-op; no torque at wrist during self-ROM; forearm supination facilitated with elbow flexed; forearm pronation facilitated with elbow extended; avoid compression/distraction exercises (push-ups, chin-ups) on gym return

Surgeon / Author

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation (Dr. Kruse, Dr. Tofte, Dr. Zachary, Dr. Israel, Dr. Salyapongse, Dr. Michelotti, Dr. Gander)