Ligament injury on the wrist
introduction
A common reason to see a doctor is a ligament injury on the wrist. It comes about through the action of external force if the degree of mobility at the wrist has been exceeded. A sports accident is almost always the cause. In the case of ligament injuries, a distinction is made between ligament stretching and ligament rupture; in some cases the capsule of the joint is also affected.
Bands on the wrist
There are various bands on the wristall of which can be affected by a ligament injury. Both ribbons between Carpal and forearm bones, as well as between the carpal bones can be damaged by a ligament injury to the wrist.
The ligaments stabilize the joint and ensure that the bones are held together. Excessive tension can stretch the ligaments; excessive force can tear the ligaments. Then the joint becomes unstable and hurts. Ligaments often affected by a ligament injury are e.g. the tape hiss Scaphoid and Moon leg (Scapholunal ligament) or the one that Moon leg and Triangular leg connects.
SL ligament injury
The so-called "scapholunary band" is known as the SL band. It is one of the strongest ligaments in the carpal bones and performs important functions. It stretches between the navicular bone and the lunar bone, two carpal bones that lie directly at the base of the wrist and are in direct contact with the ulna and radius.
The SL tape can be torn or completely severed. The treatment and prognosis largely depend on the extent of the injury.
A severed SL band is associated with a loss of stability of the wrist. In addition, there are pain, uncomfortable restricted mobility and increased snapping of the wrist. The instability and the changed mobility in the joint lead in the long term to misalignments of the carpal bones, increased wear of the joint cartilage and in the long term to osteoarthritis.
If the SL ligament is partially torn, the injury can be treated with strict immobilization if necessary.
However, over weeks and months, the bones can grow apart and make stable healing more difficult. This causes misalignments and damage to the cartilage of the wrist. In these cases and in the event of complete tears of the SL-ligament, surgical treatment must be carried out to fix the natural function of the bones.
If damage to the cartilage can already be seen, parts of the wrist may need to be stiffened. This restricts movements in the wrist, but the stiffening takes the pain away and prevents osteoarthritis.
You can find further information under our topic: scapholunal dissociation
causes
The freedom of movement on the wrist is anatomically restricted. The joint is overstretched, a wrist ligament injury is likely.
Typical causes are Sports accidentse.g. at the Ski or snowboard drive. Likewise, every fall can cause a ligament injury if you support yourself with your hand and overstretch your wrist.
Depending on the extent of the overstretching it comes to Ligament stretching or ligament rupture. In rare cases there are also chronic degenerative changes behind the ligament injury on the wrist.
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diagnosis
To diagnose a ligament injury, the wrist is first examined. If there is pain, swelling, or a hematoma, a ligament injury is likely. Together with the questioning about accidents, falls or the like, the doctor can usually make a suspected diagnosis.
It is then important differentiate between ligament stretching and ligament rupture. This is usually achieved with imaging measures. So you can see on the X-ray image an enlarged joint space from the wrist when a ligament is torn. In case of doubt, enter MRI definitive information.
Symptoms
A wrist ligament injury causes a number of typical symptoms.
Stand in the foreground Painthat arise immediately after the injury. At rest, but especially when moving, the wrist hurts, which is why function and mobility are limited.
In addition, the wrist swells due to a ligament injury, more when the ligament is torn than when the ligament is stretched. A torn ligament usually causes this Hematomawhat as bruises becomes visible on the skin.
Also read more on the topic: Torn ligament on the wrist
therapy
The therapy depends on the extent of the ligament injury and on whether there are other structures like the capsule are injured. In conservative therapy one Ligament stretch is especially Immobilization and rest appropriate, a Torn ligament may have to be operated on.
Tape for treating ligament injuries on the wrist
A tape bandage is an alternative to plaster casts and splints for mild forms of ligament tears or ligament stretching.
With the tape you can
- the muscles of the forearm strengthened,
- the blood circulation promoted and
- the wrist can be stabilized.
The tape does not achieve a complete immobilization, but only a support for stabilization. Movements are carried out more consciously with the tape, so that abrupt movements can be prevented as far as possible.
Rigid tape bandages or elastic kinesio tapes can be used for this. These are glued under tension from the back of the hand over the wrist to the forearm.
For larger tears of ligaments in the wrist, a tape dressing is not sufficient as the sole therapy.
Duration of healing
The duration of healing can vary greatly and depends heavily on:
- the respective ligament injury
- the extent of the injury
- of therapy
- the subsequent complications
Ligament stretching in the wrist can already vary greatly in its healing time.
Light strains can subside within a few days with appropriate care.
Heavy stretching of the ligaments, however, often takes several weeks to heal.
A partial tear in a ligament in the wrist can often be treated with immobilization, but it takes many weeks to guarantee stable healing.
Surgical therapies provide stability earlier after the procedure, but require a few weeks for healing and subsequent weeks for rehabilitation.
In rare cases, a ligament injury in the wrist leads to chronic complications.
Cartilage wear in the wrist is a typical long-term complication of a wrist injury. The cartilage damage cannot be healed and can often only be treated by stiffening it.
forecast
A wrist ligament injury can be treated well in most cases. Sometimes an operation is necessary. To 1-2 weeks when stretching or 6-8 weeks if the ligament is completely ruptured, the injury has healed.
Untreated permanent damage such as ligament rupture arthrosis come.
prophylaxis
Since it is usually the result of an accident, it is difficult to prevent a ligament injury on the wrist.In sport, however, it makes sense Wrist wraps and use protectors to minimize the risk of injury.
Ligament injuries in detail
Ligament stretch
In the Ligament stretch the elasticity of the tape has been exceeded without, however, tearing. The ligament causes stretching pain when exercising, one slight swelling comes in addition. The ligament stretching can be recognized diagnostically by these symptoms and by the absence of a bruise. The mobility of the wrist is limited.
In contrast to the ligament tear, no clear findings can be seen in the imaging. The ligament stretch on the wrist is treated conservatively. Immediate actions are Cooling, elevation and compression, any burden should be avoided. The healing can be through a Bandage or splint supported by immobilizing the wrist. After a week or two the ligament is healed.
Torn ligament
Of the Torn ligament on the wrist is in three degrees of severity assigned.
- Grade 1 is a partial crack with no instability
- at grade 2 the wrist is unstable
- Grade 3 describes a complete torn ligament
A ligament rupture caused severe pain and pronounced swelling. There is also a obvious bruise. In addition to the symptoms, an X-ray or an X-ray is diagnostic of this ligament injury MRIon which one can see a shift in the anatomical structures.
The therapy for this ligament injury depends on the severity. A partial ligament tear without an unstable wrist will for 4-6 weeks with a Bandage or plaster of paris immobilized.
For grade 2 or 3, surgery is indicated that will put the bones back in place and stitch the ligaments back together if necessary. The joint is then also immobilized.
Damage to the capsule
In the event of a ligament injury, there can also be a Injury to the capsule in the joint come. The capsule is then also injured by extreme movements and external violence.
Feature of a Rupture of the capsule is a severe swelling and a throbbing pain, although a crack in the capsule is often not immediately recognized. This is usually only in Ultrasound or MRI to see. A rupture of the capsule occurs at the same time as the ligament injury Immobilization in the wrist treated, the healing lasts about 6 weeks.
