Wrist Sprains

Question 1

What happens man? (5)

Answer 1

Traumatic stretching/tearing of radiocarpal, ulnocarpal, distal radioulnar, intercarpal or carpometacarpal ligs

Question 2

Tell me some stuff about these yo. 4 things to be precise

Answer 2

Mild sprains MC than fx, subluxations and dislocations
proximal row most vulnerable
Extension and radial deviation = fracture
Extension and ulnar deviation = sprain, TFC tears, dislocations

Question 3

What causes me man? What’s the MOI? (4)

Answer 3

Hyperextension (MC)

• prox row -> anteriorly w/ FOOSH
• palmar radiocarpal and scaopholunate ligs

Ulnar/radial deviation
- PURE IS RARE

Hyperflexion

• also rare
• prox row goes post
• dorsal radiocarpal and lunotriquetral ligs

Pronation/supination

• RARE
• distal radioulnar

Question 4

What are some signs and symptoms i have a wrist sprain?

Answer 4

Location of tenderness (lunate), poorly localized P
Increase pain with tension on lig
Decrease ROM
Painful clicking w jt play
+scapholunate/lunotriquetral ballottment tests
AVOID ADJUSTING DIRECTLY. Adjust around.
swelling less visible, bruising not typical

Question 5

Special tests

Answer 5

Xrays for severe sprains, cartilage tears and instability

Question 6

Rehab?

Answer 6

Pronated wrist flex/ext
Supinated wrist flex/ext
Self assisted stretching
Barbell on end deviations
Barbell on end sups/prons
Stress balls = too much distraction

Question 7

Dorsal instability AKA DISI

Answer 7

MC form!
D/t hyperextension
\+scapholunate instability
AVOID anterior lunate adjustment
Adjust adjacent carpals anteriorlyk
TERRY THOMAS SIGN

Question 8

Ventral instability VISI

Answer 8

Ventral intercalated segmental instability
RARE
D/t hyperflexion
Disassociation b/w lunate and triquetrum
Lunate goes posteriorly

Question 9

Early tx

Answer 9

Same as any other sprain
Mob/manip in NEUTRAL
Protect w/ brace