Wrist Sprains & Dislocations

A wrist sprain is very common and usually results from a fall on the hand where the wrist is bent backward. What actually occurs is the ligaments - tough, fibrous tissues that hold the bones together around the joint - are stretched beyond their limits. Sometimes they even tear. The signs of a sprained wrist are swelling, immediate and persistent paint, bruising, tenderness and a feeling of popping inside the wrist. The skin around your wrist may even feel warm to the touch. If you have these symptoms, it is important to see a physician to obtain a proper diagnosis. If you have a severe sprain, an x-ray may be requested.

Sprains are ranked into categories or grades of severity:
Grade 1: Mild sprain, indicating the ligaments have been stretched but not torn.
Grade 2: Moderate sprain, indicating some of the ligaments are torn and you may experience some loss of wrist function.
Grade 3: Severe sprain, indicating that a ligament has been completely torn. In some cases, as the ligament is torn off the bone, it can also pull a chip of bone with it. This is called an avulsion fracture. Grade 3 sprains require medical care and possibly surgery to repair the torn ligaments.

For mild sprains, the recommended treatment is often referred to as RICE: rest, ice, compression and elevation. It is optimum to rest for up to 48 hours, apply ice packs in 20-minute intervals, use an elastic bandage to compress swelling and elevate the wrist about the heart as often as possible to decrease swelling. These simple steps, along with pain medication, are usually all that is necessary to treat a mild wrist sprain. If pain persists after 48 hours, you should revisit your physician. Moderate wrist sprains often need to be immobilized, so your physician may put your wrist in a splint for a week to ten days. Severe, grade 3 sprains may require surgery to repair the torn ligaments. If surgery is recommended, it will be followed by rehabilitation that includes exercises to strengthen the wrist and help you regain normal motion. Overall, depending on the severity of the sprain, it can take as little as two, or as many as 10 weeks for a wrist sprain to properly heal.

More severe than a wrist sprain is a wrist dislocation, where one or more bones within the wrist has come out of place. Based on the severity of the injury, your physician will recommend the proper treatment for your particular wrist dislocation. Reduction, or the repositioning of a bone to its normal position, can often be accomplished without surgery, though it does require sedation. Sometimes surgery is necessary to realign the dislocated bone. In either case, the goal is always to restore the original alignment and rotation of the bone, to decrease pain and prevent any deformity down the road, and to restore normal use of the wrist. Rehabilitation is a vital part of recovery. Once healing has begun and the pain has diminished, therapy will be prescribed to stretch and strengthen the area muscles and help restore full motion and functionality. It is wise during this time to avoid any activities that could impact your recovery.