Wrist Sprains

• Wrist Sprains:

  • very common - particularly in the younger age groups
  • usually caused by a FOOSH
  • graded from 1 to 3 depending on the proportion of fibres that have been involved and the extent of the damage
  • same principles as for lower limb injuries:
  • PRICE
  • gradual return to ROM, strength and then function
  • grade 2 injuries - wrist splint for a week or until imaging rules out scaphoid fractures or scapholunate ligament injury
• Wrist Sprains:

  • when to be concerned:
  • scaphoid fracture
  • scapholunate ligament injury
  • clues:
  • pain tenderness and swelling in anatomical snuff box or over palmar tubercle
  • swelling and limited grip strength and ROM
  • clicking and pain in dorso-radial aspect of the wrist
  • severity of pain
  • severity of impact
• Wrist Sprains - scapholunate ligament injury:

  • Scapholunate ligament is important for carpal stability - chronic scapholunate deficiency leads to instability
  • The theorized mechanism of injury is high energy trauma, usually from a FOOSH with extension, intercarpal supination and ulnar deviation, causing failure of the scapholunate interosseous ligament and scapholunate dissociation
  • Often this manifests as impact to the hypothenar eminence
  • Management – immobilise for 2 - 4 weeks
  • Post-immobilisation: build capacity in ROM and strength and return to function