Wrist Sprain

Overview

Wrist sprains are common injuries that result when the wrist is forcefully bent or twisted beyond its normal range of motion, causing pain and instability in the joint.

Anatomy

The wrist is made up of eight carpal bones and the ends of the radius and ulna. The carpal bones are arranged in two rows between the radius and ulna and the metacarpals. Strong ligaments connect the carpal bones to each other and to the radius, ulna, and metacarpals. It is these ligaments and the joint capsule, a sac of tissue that encases the bones and ligaments of the wrist, that are injured in a sprained wrist.

Causes

The majority of wrist sprains are caused when a person tries to break a fall with an outstretched hand. The impact forces the hand backward, stretching or tearing the wrist joint capsule and ligaments. Wrist sprains can also be caused by forceful flexion or twisting of the wrist. Other common causes are contact sports, fights and automobile accidents. A power drill that binds and kicks back against the hand can also cause a wrist sprain. The most commonly injured tissues are the joint capsule, the scapholunate ligament, and lunotriquetral ligament.

Symptoms

The most common symptoms are pain, difficulty with wrist movement, and weakness. In some cases, swelling and bruising may also occur. If a ligament has been seriously injured, the bones of the wrist may pop or shift when the wrist is moved.

Diagnosis

A suspected wrist sprain is diagnosed with x-rays of the hand and wrist. X-rays will allow the physician to assess the position of the bones and rule out a fracture. An MRI and arthrogram may also be ordered to further assess the wrist ligaments. In some cases it is necessary to look inside the wrist with a tiny camera called an arthroscope to diagnose and treat a ligament tear.

Treatment

Many patients, especially those who have injured a wrist during sports, self-treat a sprained wrist by taping and resting the wrist. If wrist pain lasts more than a day or two after the event, medical care is needed. Early treatment for a wrist sprain usually includes a period of rest in a splint or cast, ice, compressive wrap, and elevation of the wrist to reduce swelling. Anti-inflammatory medications may also be recommended. Hand therapy may be recommended to help relieve joint stiffness and improve strength as the sprain heals. Surgery may be required if a torn or stretched ligament results in joint instability or chronic pain. More complex surgeries are required if a patient has a significant tear and waits several weeks to see a physician.

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