The symptoms of a wrist cartilage and ligament tear
A wrist strain is a stretched or torn ligament.
What are the most common causes?
- The most common cause is a fall on the outstretched wrist.
- A twisted wrist is the second most common cause.
- Sprains are also common sport injuries.
What are the symptoms?
Wrist strains cause pain, inflammation and stiffness, though symptoms may not all be present at the same time.
How is it diagnosed?
A history of the patient’s activity is important in evaluating the injury, because the same type of injury can also create fractures. X-rays are essential and an arthrogram or MRI may be required.
Arthrogram / MRI
The most common ligament tears
Scapholunate complex tear
The scapholunate ligament is a key element in stabilizing the foundation of the wrist (the scapholunate joint). A tear can be serious and can, if left untreated, as is often the case, lead to instability of the wrist, pain, stiffness, loss of grip strength and irreversible osteoarthritis. A tear can be partial or complete, stable or unstable.
Luno-triquetral ligament tear
This ligament stabilizes the ulnar, or inner, side of the wrist. Tears are common and cause pain and wrist instability. A tear can be partial or complete.
Triangular fibrocartilage complex (TFCC) tears
The TFCC is similar to a meniscus in the knee, and like its counterpart, has minimal vascularization. Only peripheral tears have the potential to heal and can be treated through surgical arthroscopic fixation or, if the wrist is unstable, open surgery.
Treatment of this type of ligament injury must be prompt and precise. If delayed, arthroscopic debridement and pinning can be an option, but ligament reconstruction with a tendon graft might be required to stabilize the scaphoid and the first row of wrist bones. Alternatively, a partial wrist fusion or a wrist arthroplasty may be required.
Arthroscopic treatment and pinning for six weeks, followed by therapy. Results might be less successful for old lesions, and pain-relief measures could be prescribed.
Should immobilization prove insufficient, central tears can be treated by arthroscopic debridement. In some cases, when the ulna is too long, a shortening procedure is also performed to decrease the pressure of the medial side of wrist and allow healing.