The wrist is a collection of eight small bones that connect the forearm bones (radius and ulna) to the bones of the hand (metacarpals). These small bones have a complex series of ligaments that control smooth wrist movement. Any injury to these ligaments may cause abnormal motion between some of the bones of the wrist.
Usually trauma, such as a fall on a flexed or extended wrist. A direct blow to the wrist may injure ligaments.
Pain, swelling, or weakness in the wrist. There can occasionally be a sense of ‘popping’ or ‘slipping’ inside the wrist. Symptoms are generally worse with activity, such as gripping, squeezing, and lifting.
Tenderness over specific wrist ligaments. Swelling, loss of motion, and weakness. Certain special tests are suggestive of specific ligament injuries.
History, physical examination, and x-rays are required. Specialized x-rays, including stress x-rays or real-time motion studies are often obtained. An injection of local anesthetic into the area is helpful in confirming the diagnosis. Rarely, an MR scan or arthrogram is obtained. The high error rate of these tests in this injury makes them of limited value. The definitive diagnostic tool is a wrist arthroscopy.
Splinting or casting for several weeks will allow partial ligament tears to heal.
An arthroscopy will confirm the diagnosis. Many ligament injuries can be treated entirely arthroscopically, but open ligament repairs or other reconstructive procedures are occasionally required.
While most wrist sprains heal uneventfully, early recognition of more severe injuries will help to prevent the often devastating complications of this injury.