Occupational triangular fibrocartilage complex injury in a sewing machine operator

Abstract

Triangular fibrocartilage complex (TFCC) injuries are associated with repetitive wrist movements and have mostly been reported in athletes but not in sewing machine operators, even though their jobs involve repetitive wrist movements. Our patient had operated a sewing machine for nine years across various workplaces. Two years ago, she began experiencing lateral ulnar pain, tenderness, and mild swelling in her left wrist. She was initially evaluated by her family physician, then by an orthopaedic surgeon, and was eventually referred to an occupational medicine specialist. TFCC compression test, TFCC stress test, grind test, and supination test were all positive. Ergonomic assessment showed an arm-wrist score of 5, a total rapid upper limb assessment (RULA) score of 5, and a job strain index (JSI) score of 13.5. Magnetic resonance imaging (MRI) of the left wrist showed changes consistent with a TFCC injury. Treatment included wrist immobilisation, oral painkillers, and rest, but her symptoms persisted upon return to the sewing machine, despite temporary use of a brace. Partial symptom improvement was observed only after job reassignment. This report presents the first confirmed case of a TFCC injury in a sewing machine operator and suggests that its potential occupational risks may have been overlooked in this population.