Untitled
Wrist Sprain
A wrist sprain is an injury to one or more of the ligaments that support the wrist joint.
The wrist is an intricate collection of joints. The forearm contains the radius and the ulna bones, the distal (furthest from the body) ends of which connect with the proximal (nearest the body) row of carpal bones of the wrist. A second row of carpal bones, the distal row, connects with the metacarpals (long bones) of the hand.
Ligaments, which are fibrous and elastic bands of connective tissue, join one bone or structure to another. They stabilize joints, keeping the bones in position and allowing a certain amount of movement. Some ligaments specifically restrict movement in a particular direction. Movement of a joint beyond its normal range of motion can tear some ligament fibers or, in more severe cases, completely rupture a ligament. With a severe injury the ligament may tear in its middle part, or rip away from the bone.
Because the wrist is such a complex arrangement of joints, damage to any of the supportive ligaments is a potentially serious injury.
Causes:
A fall onto an outstretched hand is the most common cause of a wrist sprain, but any impetus strong enough to force the wrist to move beyond its normal range of motion, such as a blow or twisting, will damage the ligaments. Sporting and outdoor activities are commonly responsible for these injuries.
Symptoms:
The amount of pain in the wrist after a trauma, or the degree of flexibility, may not accurately reflect the level of injury, so you should seek medical attention for any symptoms that do not go away after a day or two. You should immediately seek attention for extreme pain, numbness or deformity.
Symptoms may include:
- Pain at the moment of injury
- Swelling
- Bruising
- Heat or warmth in the skin at the wrist
- Sensation of popping or ripping inside the wrist
- Diminished ability to move the wrist due to pain
- Deformity of the wrist
Diagnosis:
After asking for your medical history and the details of any previous injury to your wrist, your doctor will ask you about the circumstances of your current injury, and the onset, duration, and severity of your symptoms. He or she will then physically examine the wrist, touching and moving it in particular ways to determine the location and severity of the injury. Your entire arm will be assessed for other damage, and the nerve and blood circulation checked.
X-rays will be taken to look for any bone fracture or bone dislocation. Sometimes an occult (hidden) fracture may be present. An MRI (magnetic resonance imaging) scan or CT (computed tomography) scan may be performed as these show the soft tissues of the body and will clearly show damage to any ligaments. An arthrogram is another diagnostic test that shows the joint and ligaments clearly through the injection of a dye into the joint.
Wrist sprains are graded according to severity, with Grade I being a relatively mild injury with some partial tearing of ligament fibers, but a stable joint. Grade II are moderate sprains with more extensive damage to the ligament and a degree of instability in the joint. Grade II sprains refer to a completely ruptured ligament, where the ligament has been torn and the wrist joint is unstable.
Treatment:
Unless there is an obvious deformity of the wrist, numbness or extreme pain, you can try some self-help measures at home before you decide if you need to see your doctor.
You must rest the wrist completely. Avoid any activity that may cause further damage. Apply crushed ice, in a bag and wrapped in a towel, to your wrist for as long as is comfortable, several times a day. This will help reduce swelling and so will ease pain. Applying an elastic bandage will compress the wrist and make you feel more comfortable. Elevating the wrist above the level of your heart will also help reduce swelling. You can take acetaminophen (Tylenol) or NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil), naproxen (Aleve) or similar for pain and inflammation relief.
If your symptoms have not gone away after a day or two, see your doctor for a proper diagnosis and treatment.
Based on your particular injury, your doctor may place your wrist in a wrist splint or cast for at least a week. A splint will allow you to take it off when necessary. Splinting or placing the wrist in a cast will effectively immobilize the joint and give the ligaments time to heal. Stiffness after immobilization is common, so you are likely to be given some exercises to do to regain mobility and strength in the wrist.
A more severe injury may need surgical repair. The exact procedure would depend on the type and location of your sprain, but the goal of any surgery would be to restore stability and range of motion to the wrist. The various options would be discussed with you to help you reach the best decision. Following surgery your wrist would be immobilized for a period of time, dependent on the type of procedure, following which you would need to undertake a program of stretching and strengthening exercises to rehabilitate the wrist.
Prognosis:
An untreated wrist sprain may lead to chronic joint instability that, in time, can cause degeneration of the cartilage in the wrist. The result could be the development of arthritis, and surgery to try to alleviate painful symptoms could become necessary.
With proper diagnosis, treatment, and rehabilitation a wrist sprain should heal well.
Exercises:
Follow medical advice as to when to begin doing exercises. Repeat each exercise 10 times for 1 set. Do 3 sets.
Flex, extend, and side-to-side:
Simply bend the wrist forwards and hold the stretch for 5 seconds. Then bend the wrist backwards and hold the stretch for 5 seconds. Move the wrist from side to side (as in a handshake) and hold at the furthest point at each side for 5 seconds.
Ball grip:
Gently squeeze a rubber ball, hold the squeeze for 10 seconds, then release. As strength in the hands builds, you will be able to squeeze harder.
|
|
