Symptoms of a Torn Wrist Ligament

What is a wrist ligament?

A ligament is a dense, fibrous connective tissue that joins the end of one bone to another. Ligaments are attached to ends of bones, and in a joint, they strengthen and stabilize the joints by preventing uncoordinated, excessive motion of the bones.

The ligaments of the wrist are tissues that connect the eight (8) bones of the wrist also called carpals to each other. These dense structures also join the carpals to the bones of the lower arm (ulna and radius) and the metacarpals. The wrists ligaments are important for the motion of the hand: dorsiflexion (hand moves up), palmar flexion (hand moves down), radial and ulnar deviation (hand moves side to side).

The wrist ligament along with the other connective tissues of the hand stabilizes the wrist and aid movement at the wrist joint. Damage to the ligament can interfere with normal support at the wrist, and also hamper the proper use of the hand. A common hand ligament injury occurs at the base of the wrist. This injury occurs in the scapholunate ligament. This ligament joins the scaphoid and the lunate bones – proximal bones of the carpals – and make up the base of the palm.

What are the causes of a torn wrist ligament?

While anybody can suffer a torn wrist ligament, the injury is most common among professional athletes such as football players, divers, gymnasts, golfers, heavy weightlifters, baseball players, etc.

Injury to the wrist ligament can be caused by several factors. Some of the causes of torn wrist ligament are a repetitive use of the hand, acute trauma from torquing motion due to bad falls, wear and tear, and excessive, unbalanced weight on the joint.

The most common cause of a torn wrist ligament is a fall on an outstretched hand. When this happens, the degree of damage to the wrist ligament depends on the strength of the individual (that is if the hand can support the weight of the body), pre-existing conditions affecting the wrist joint, etc. Most traumas to the ligament do not always result in a torn ligament. In some cases, wrist sprains can occur.

What are the symptoms of a torn wrist ligament?

Damage to the ligament of the wrist can cause severe pain and swelling of the wrist, reduced range of motion (ROM), tenderness, bruises, and discoloration (called ecchymosis). Pain and swelling can worsen if care is not provided to repair the ligament. The decrease in ROM in the wrist can affect the flexibility of the hand and can make it difficult for patients to complete regular tasks.

When left untreated, a torn wrist ligament can increase the risk of osteoarthritis. Osteoarthritis is a serious joint condition associated with severe pain and can limit wrist movement.

How to diagnose a torn wrist ligament?

Diagnosing a torn wrist ligament requires a thorough medical review, occupational/work history, and physical examination. Surgeons will evaluate patients for swelling in the wrist, range of motion, muscle grip strength, alignment, and joint stability.

X-rays images and MRI scans of the wrists can be used to evaluate bone fractures, carpals’ alignment, and ligament tears. X-ray images of the wrist can be used to visualize bone fractures and carpal alignments. In arthrography, a special dye, an arthrogram, is injected into the wrist, and with MRI scans, it can be used to improve the diagnosis of a torn wrist ligament.

Treatment of a torn wrist ligament

It is very important to treat a torn wrist ligament immediately. When left untreated, it can cause lasting damage to nerves, tendons, bones, and muscles.

Non-surgical treatment

Non-surgical procedures for treating torn wrist ligament often involves minimizing symptoms of the injury. In some cases, splinting/immobilizing of the affected wrists for up to four (4) to six (6) weeks can reduce pain, swelling, and tenderness. Prolonged use of a splint can cause stiffness of the joint.

Doctors can administer NSAIDs (non-steroidal anti-inflammatory drugs) for example ibuprofen/aspirin for pain and inflammation (swelling) management. Physical therapy such as stretching and strengthening exercises can improve the range of motion (ROM) of the wrist joint, enhance grip strength, and promote healing of the ligament.

Surgical treatment

In severe cases of torn wrist ligament or when non-surgical treatment options have been ineffective, surgery is typically recommended. The most common surgical procedure for repairing a torn wrist ligament involves arthroscopy.

Arthroscopic surgery is a less invasive procedure. It involves the insertion of a small camera through a tiny incision made on the wrist. Wrist arthroscopy allows hand surgeons to visualize the bones and ligaments of the wrist to guide the ligament repair.

Pinning repairinvolves the insertion of metallic pins to support the bones of the wrist until the ligaments heal. The pins are usually removed after the tissues have healed. This procedure is more effective when the injury is still fresh.

Reconstruction repair is often recommended for ligament injuries that occurred a long time before treatment – usually over six months. This procedure involves replacing the torn ligament with a tendon graft. During the healing process, the wrist is immobilized with metal pins.

Fusion repair is adopted when arthritis is present at the wrist joint. The bones of the wrist joint are fused to minimize joint pains during motion.

Post-operative management of torn wrist ligament

Following surgery, doctors advise patients to immobilize the wrist by wearing a cast or splint. Weeks after the surgery, the splint is removed. Wrist therapy is recommended (for both non-surgical and surgical rehabilitation) to improve the range of motion at the wrist joint and to reduce stiffness. Physical therapy aids recovery and facilitates normal joint alignment during recovery.

Citations

1. EPainAssist, Team. “Torn Ligament in Wrist|Symptoms|Treatment|Surgery.” EPainAssist, 19 Jan. 2018, www.epainassist.com/sports-injuries/wrist-injuries/torn-ligament-in-wrist.
2. “An Overview of Wrist Sprain.” WebMD, 1 Feb. 2007, www.webmd.com/fitness-exercise/wrist-sprain#1.
3. “Wrist SprainsOrthoInfoAAOS.” orthoinfo.aaos.org/en/diseases–conditions/wrist-sprains.
4. “Ligament Injuries of the Wrist.” Orthopedic Surgery, Algonquin, IL, Barrington, IL, Elgin, IL, Geneva, IL, 25 Mar. 2013, midwestbonejoint.com/wrist/ligament-injuries-of-the-wrist/.