Wrist sprains and dislocations involve injury to the ligaments of the wrist. Ligaments are made of strong fibrous bands of tissue that attach and hold bones together across joints. The ligaments of the wrist joint are very complex which allow for intricate controlled motions between the bones of the wrist. Sprains occur from overstretching and tearing of these ligaments from an overload or violent motion to the joint, which range from minor injuries to more severe injuries such as a wrist joint dislocation (such as perilunate dislocation or lunate dislocation of the wrist). Minor wrist sprains are associated with stretching of the ligaments, whereas moderate sprains involve partial tearing of ligaments. Complete tearing of ligaments occurs with more severe sprains which may cause instability patterns of the wrist depending on the ligaments torn. One of the more commonly torn ligaments is the scapho-lunate ligament which links the scaphoid bone to the lunate bone of the wrist. When joint instability results from inadequate treatment, chronic pain and arthritis typically develop in time.
Treatment for minor wrist sprains typically consists of conservative measures. Most minor sprains respond well to modification of activities, splinting, stretching, and use of anti-inflammatory medication. Steady improvement can be expected over 6 to 8 weeks although joint stiffness can be more persistent. For more severe sprains involving tears of important ligament structures, particularly those of the smaller carpal bones of the wrist, surgery may be necessary which can range from different techniques of wrist arthroscopy to complex reconstructions of the wrist ligaments. When more advanced chronic instability patterns of the wrist develop, partial fusions of the wrist bones may be necessary. For more complex ligament and dislocation injuries of the wrist, surgical options each have limited success and may only be suitable for select patients. Details of each type of wrist injury and possible treatment, whether managed with or without surgery, are discussed in detail by Dr. Katz with each patient to help you choose the treatment that is best for you.