Hand & Wrist Center of Houston Home If you suspect broken bones, dislocated joints, lacerated tendons, lacerated nerves, infection, or have an open wound below the elbow, then call us immediately.
 
WRIST LIGAMENTS


WHAT YOU SHOULD KNOW

Wrist DislocationThe ligaments that stabilize the many connections inside the wrist joint are critical for normal functioning of the wrist. They are extremely short and tight ligaments rather than long cords like certain other ligaments in the body. Once they are torn, there is a short opportunity of around a month to get them repaired before they shrink away. After this time the strategy for recovering function of that ligament changes from repair to reconstruction and becomes a much larger scale treatment.

MEDICAL HISTORY

Early after injury patients usually recall the specific injury event followed by pain, swelling, stiffness, and weakness. Later the patient may note primarily weakness and a sense of giving way when trying to use the wrist for more strenuous activities. Some patients note a "popping" or "clicking".

EXAMINATION

Pressure applied over the damaged ligament usually produces tenderness. The joint may have lost motion. But the key to the examination is testing the function of each specific ligament with stress maneuvers.

ADDITIONAL TESTS: A test called an arthrogram was previously used to test for breaks in the ligaments but has been shown to be highly inaccurate and not relevant to ligament function. Magnetic resonance images (MRI) is more accurate than arthrogram regarding breaks in the ligament but gives absolutely no information regarding the functional performance of the ligament and is far less useful than a physical examination by a dedicated wrist surgeon. The only truly accurate test for ligament injury is direct examination by a fiber optic camera (arthroscopy) while testing the ligament under stress.

TREATMENT OPTIONS

 NON-OPERATIVESURGICAL REPAIRSURGICAL RECONSTRUCTION
CONSISTS OFEarly range of motion exerciseArthroscopic repairTendon transfer or graft
FEATURESRegaining full motion of the wrist is followed by strengthening of specific muscle groupsOutpatient surgery, fiber optic camera guides ligament alignmentSeries of limited incisions allows rerouting of tendon material through passages in bone to stabilize joint
ADVANTAGESAvoids surgeryHeals the original ligament at its correct attachmentsCan be used at any time prior to collapse
DISADVANTAGESOnly useful for partial tears that do not affect wrist stabilitySome permanent stiffness resultsMore invasive, reconstruction can never truly reproduce the function of the original ligament

RECOVERY

Sutures are removed in the office at 2 weeks and a cast applied. The ligaments must be immobilized to heal correctly. Pins that prevent forearm rotation are removed at 4 weeks post-op. Pins buried under the skin in the small wrist bones are removed under local anesthesia at 8 weeks post-op. Once all pins are out, exercises are started in outpatient therapy to regain as much motion as possible. Once motion has maximized, strength is developed. The whole process keeps the patient in rehabilitation for at least 4 months. Final range of motion and strength always remain partially diminished after major wrist ligament injuries.
 
 
 
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  • I am very pleased with the service received from Dr. Henry. He is a very great doctor. - 09/19/11
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  • This entire experience thus far has been amazing. The staff has been great and very helpful. Thank you hand and wrist center. - 08/02/11
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  • I've already recommended others to Dr. Henry because of his outstanding abilities to take care of his patients and his excellent staff of professionals. - 02/08/12
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  • Outstanding from start. Already recommended to friend - 12/19/11
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