Wrist Sprains
Hand and Finger Procedures & Conditions | Dr. William Van Wyk, DFW Hand Surgeon
Wrist Sprains
Hand and Finger Procedures & Conditions | Dr. William Van Wyk, DFW Hand Surgeon
Click image to enlarge
Photo Credit: American Society for Surgery to the Hand
What are wrist sprains?
A wrist sprain is an injury to a ligament. Ligaments are the connective tissues that connect bones to bones; they could be thought of as tape that holds the bones together at a joint.
Fig. 1: Ligaments of the wrist are injured with a sprained wrist.
How do wrist sprains occur?
Wrist injuries are common in falls and sports. The wrist is usually bent backwards when the hand hits the ground such as when someone slips or trips and falls. These injuries also frequently occur during sports such as football and snowboarding. After injury, the wrist will usually swell and may show bruising. It is usually very painful to move.
Click image to enlarge
Photo Credit: American Society for Surgery to the Hand
What are the most common types of wrist sprains?
The most common ligament to be injured in the wrist is the scapho-lunate ligament (Fig. 2). It is the ligament between two of the small bones in the wrist, the scaphoid bone and the lunate bone. There are many other ligaments in the wrist, but they are less frequently injured. Sprains can have a wide range of severity; minor sprains may have minimal stretch of the ligaments, and more severe sprains may have complete ruptures of the ligament(s).
Click image to enlarge
Photo Credit: American Society for Surgery to the Hand
How are these injuries treated?
Initially your doctor will examine your wrist, to check its flexibility and stability and to see where it hurts. X-rays are taken to check the alignment of the wrist bones and to check for any fractures (Fig. 3). Occasionally other studies such as Magnetic Resonance Imaging (MRI) may be performed to help determine the diagnosis. Treatment may range from immobilization in a splint or cast to surgery. Surgery may consist of arthroscopic or open surgery.
Arthroscopic surgery is performed through small (3-4 millimeter) holes in the skin where a camera and other special instruments are placed inside the wrist to confirm the diagnosis and potentially treat the ligament injury.
Some injuries require open surgery in which an incision is made to repair and/or reconstruct the ligament. A variety of methods exist, which could include metal pins, screws, and other specialized devices. Patients are usually placed in a splint or cast after surgery which may need to remain on for 6-12 weeks after surgery. Your doctor will determine the best course of treatment.
Chronic wrist injury
The term chronic refers to an old injury of greater than several months to years. If there is no or minimal cartilage damage, the ligament may be reconstructed as discussed above. If there is moderate to severe cartilage damage (arthritis), symptoms may be pain, stiffness, and swelling. These may be first treated with splinting and non-steroidal anti-inflammatory medicines, and later with cortisone injections. If these treatments fail, surgery may be an option. This may be a partial wrist fusion, removal of arthritic bones ( proximal row carpectomy ), wrist replacement, or complete wrist fusion. Your doctor will determine the best course of treatment.
Associated injuries
Occasionally fractures occur along with wrist sprains. These may require additional surgery to repair the fracture with metal pins, screws, or plates. Cartilage damage may also be present which does not show up on the x-ray.
What you can expect from these injuries
Despite optimal treatment, wrist sprains occasionally result in residual long term pain, stiffness, and swelling. The wrist is a complex group of bones, cartilage, and ligaments that are in a delicate balance for precise movements. Injury can upset this balance and damage previously well-tuned moving parts.
Future treatments
There is much research underway searching for better methods to treat these serious injuries. They include stronger and more precise ligament reconstructions using either local tissues (tendons) or distant tissues (ligaments from the hand or foot).
Material modified from the American Society for Surgery of the Hand.
I couldn’t ask for a better Hand specialist.
Google Review, Ernie F., January 2024
I was referred to Dr William VAN Wyk for a bone contusion in my right wrist. From the moment the Dr came into the room. I knew I was in good hands. He recommended surgery which he performed st a surgical facility. Everything couldn’t have gone any smoother. I visit them now weekly for therapy. His entire staff is so attentive and caring makes a patient feel great and he always comes out to see how therapy is going.
Board Certified Orthopedic Surgeon Specializing in Hand & Upper Extremity Surgery in Fort Worth Since 1977
Dr. Van Wyk is a hand and upper extremity specialist actively practicing in Fort Worth since 1977. Dr. Van Wyk is board-certified in orthopedic surgery and has practiced in that specialty. He passed the added qualification in hand surgery exam and has limited his practice to 100% hand and upper extremity surgery.
In Dr. Van Wyk’s practice, upper extremity surgery refers to the elbow, forearm, wrist and hand. As a hand specialist, he sees approximately 300 hand patient visits per month and performs on average 90-100 surgical procedures per month. Dr.Van Wyk is a member of the American Society for Surgery the Hand, American Academy of Orthopedic Surgery, the American Board of Orthopedic Surgery, Fort Worth-Dallas Hand Association, the American Medical Association, and the Tarrant County Medical Association.
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