Sprained ligaments of the hand

A sprained wrist is damage to the fibrous tissue bundles that provide articulation of bones in joints as a result of mechanical overload that has exceeded their physical strength.

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Causes of Wrist Sprains

From an anatomical point of view, the causes of sprains of the wrist ligaments (as well as sprains of other ligaments) are that at the moment of traumatic impact, the joints of the wrist, strengthened by the ligaments, are in a position that goes beyond the range of their functional movements. In order to hold the bones in the joint, the ligament fibers stretch to the extreme limits of their capabilities. And in this case, they perform their second most important function - they limit the mobility of the bones in the joints in the proper position.

Due to the parallel collagen fibers, the ligaments are strong, and due to the elastin fibers, they are quite elastic. But strength is directly dependent on the transverse size of the ligament, and elasticity and extensibility (resistance to deformation) depend on the length. That is, the narrower and shorter the ligaments (as in the hand), the less their strength and elasticity.

Most often, sprains of the ligaments of the hand occur with the lateral (collateral) ligaments of the wrist joint (radial and ulnar), scapholunate ligament, lunate triquetral ligament, and also the lateral ulnar ligament of the metacarpophalangeal joint of the thumb.

Among them, the leading strain is in the area of the wrist joint, which provides flexion, extension and circular movements of the hand. Traumatologists explain this by the fact that more than a third of all the bones of the hand (8 out of 27) are located in the wrist, and all the bones are connected to each other by ligaments. Therefore, with such a complex structure, functional differentiation of individual ligaments and intense loads on the wrist, the level of its traumatic injuries - in particular, ligament sprains - is very high.

As noted by specialists in the field of the musculoskeletal system, the key causes of sprained wrist ligaments are: excessive tension when falling on arms straightened at the elbow joint; a strong blow; lifting weights (especially when trying to abruptly tear them off the plane or lift them up from shoulder level); holding body weight in the absence of support (for example, when hanging and pulling up on a bar). In general, this type of injury occurs both in sports and physical education, and in everyday life.

It should be borne in mind that a severe sprain can be accompanied by a rupture of the ligaments, and especially often in cases of impact and fall on the wrist, the scapholunate or lunate-triquetral ligament is torn.

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Symptoms and diagnosis of wrist sprains

Symptoms of a sprained wrist depend on the level of damage to their fibers. If the damage is mild, the pain is minor, but increases with movement (flexion-extension of the wrist) or with pressure on the joint.

When the degree of ligament damage is moderate, the pain is severe, hand movements are limited, and swelling of the soft tissues is observed (especially intense in the first days after the injury).

With a severe sprain, ligament rupture often occurs, which is characterized by: intense sharp pain, diffuse swelling of the joint, reddening of the skin and subcutaneous hematoma (hemorrhage) at the site of injury, as well as either a complete inability to move the hand, or non-physiological increased mobility (instability) of the joint.

Diagnosis of sprained wrist ligaments is carried out based on the clinical picture of the injury (during the examination by a doctor), patient complaints and their descriptions of the circumstances in which the injury was sustained. X-ray examination of the wrist is mandatory (if a crack or bone fracture is suspected - in several projections). Usually this is quite sufficient for therapeutic recommendations, the implementation of which will improve the condition and eliminate the consequences of the sprain.

Treatment of wrist sprains

In most cases, stretched and even torn ligaments return to their original state and heal themselves. However, treatment of sprained wrist ligaments is still necessary, and it should be started immediately after the injury.

Complete immobilization (immobilization) of the hand and arm is mandatory: the hand is bandaged tightly enough, but so that the fingers do not turn blue or cold; it is advisable to place the arm bent at the elbow on a supporting bandage secured behind the neck. In case of sprains with ligament rupture, so-called rigid immobilization of the hand is performed (plaster cast with a special bandage).

It is mandatory to apply cold compresses (ice is best) to the injured area for two days - for 20-30 minutes every 3-4 hours. This will help reduce swelling and pain.

Also, to reduce pain, nonsteroidal anti-inflammatory drugs (NSAIDs) are taken orally - Ibuprofen, Nurofen, etc. (one tablet twice a day). Of the analgesics for external use, traumatologists recommend ointments and gels Finalgon, Diclofenac (Voltaren), Fastum gel (Ketonal), Nise gel (Nimesulide) - lubricate the skin over the damaged area 4-5 times a day).

As swelling and pain subside, physical therapy for sprained wrist ligaments begins, which includes: exercises to develop the joint and expand the range of motion, electrophoresis, and UHF.

If prolonged instability of a joint, especially the wrist, occurs as a result of a ligament rupture, orthopedic surgery may be performed to reconstruct the damaged ligaments.

Prevention and prognosis of wrist sprains

What can be done to prevent a sprained wrist? Be careful when walking on slippery, wet and uneven surfaces (so as not to fall), prevent injuries in the gym, on the tennis court, on a regular sports ground. If the load is too heavy, do not try to lift it at all costs: remember about sprained ligaments, and not only the wrist…

If everything was done correctly after the injury (as described above), then the prognosis for sprained wrist ligaments is positive. However, if the injury is treated lightly, then you can get partial or complete loss of mobility of the injured joint, as well as arthrosis or arthritis.