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Wrist Ligament Injuries

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Dr Jacqueline Tan

MBBS (SG) | MRCS (Edin) | MMed (Surgery) | FAMS (Hand Surgery)

Wrist ligament injuries involve damage to the bands of connective tissue that stabilise and support the wrist’s complex joint structure. These injuries may occur due to trauma, overuse, or degenerative changes.

Ligament injuries can range from mild sprains to complete tears, affecting wrist functionality and causing significant discomfort. Timely diagnosis and appropriate management are necessary for optimal recovery.

Symptoms of Wrist Ligament Injuries

Wrist ligament injuries can present with a range of symptoms depending on the severity and specific ligament affected. Common symptoms include:

  • Pain and Swelling: Tenderness, swelling, and pain, especially during movement or when pressure is applied to the wrist.
  • Limited Range of Motion: Difficulty bending, straightening, or rotating the wrist due to pain or mechanical instability.
  • Weakness and Instability: The wrist may feel weak or unstable, with some individuals experiencing a sensation of the wrist ‘giving way’ during activity.
  • Clicking or Catching Sensation: Clicking, popping, or catching in the wrist joint, often resulting from disrupted alignment or function.
  • Bruising and Stiffness: Visible bruising may accompany reduced flexibility or stiffness in wrist movement.
  • Tingling or Numbness: Some individuals may notice tingling or numbness in the wrist or fingers, particularly if nerve involvement is present.

Causes and Risk Factors

Wrist ligament injuries can result from various factors. Identifying these causes aids in prevention and management.

  • Trauma: A sudden impact or twisting injury, such as a fall onto an outstretched hand, is a common cause of ligament damage.
  • Sports Injuries: High-impact sports or activities involving repetitive wrist movements and heavy lifting increase the risk of ligament strain or tears.
  • Overuse: Prolonged or repetitive stress on the wrist, common in certain occupations or hobbies, can weaken ligaments over time, leading to injury.
  • Degenerative Changes: Age-related wear and tear can gradually weaken ligaments, making them more vulnerable to damage.
  • Pre-existing Conditions: Conditions such as ligament laxity or joint instability may predispose individuals to wrist ligament injuries.

Types of Wrist Ligament Injuries

Wrist ligament injuries vary depending on the specific ligament affected and the severity of the damage. Common types include:

Scapholunate Ligament Injury

Damage to this ligament often results in wrist instability, persistent pain, and reduced grip strength, significantly affecting daily activities.

Lunotriquetral Ligament Injury

This injury affects wrist stability and movement, typically causing pain on the ulnar (outer) side of the wrist and occasional clicking or locking sensations.

Triangular Fibrocartilage Complex (TFCC) Tears

The TFCC helps stabilise the small bones and ligaments of the wrist. Tears can lead to pain, reduced range of motion, instability, and difficulty with rotational movements.

Wrist Sprains

These injuries involve ligament stretching or tearing. Mild sprains (Grade I) show no tearing and cause minimal discomfort, while severe sprains (Grade III) involve complete tears, often resulting in significant instability and potentially requiring surgical repair.

Diagnosis of Wrist Ligament Injuries

Medical History

Your doctor will collect detailed information about how the injury occurred, the symptoms experienced, and any prior wrist conditions. These details aid in determining the likely cause and guiding subsequent diagnostic steps.

Physical Examination

The wrist is assessed for range of motion, strength, and stability, with attention to signs such as tenderness, swelling, bruising, or deformity. Specific actions or pressure tests may be used to locate pain and evaluate ligament functionality.

Imaging Studies

Imaging confirms the diagnosis and evaluates the extent of the injury. X-rays are used to detect fractures or joint misalignment, while MRI or ultrasound provides detailed views of soft tissue damage, including ligament tears. CT scans offer high-resolution imaging for bone and joint structures when finer details are needed. The choice of imaging depends on the suspected severity and type of injury.

Treatment Options

Treatment for wrist ligament injuries depends on the severity of the injury and the specific ligament involved. Non-surgical options are usually considered first, with surgical interventions reserved for more severe cases.

Non-Surgical Treatment

Rest and Immobilisation

Using a wrist splint or brace limits movement and provides support, creating an environment for the ligament to heal naturally. Immobilisation reduces strain on the injured ligament, preventing further damage and promoting recovery over several weeks.

Physical Therapy

Therapeutic exercises focus on strengthening the muscles surrounding the wrist to enhance stability. Stretching exercises improve flexibility and help prevent stiffness that can result from immobilisation or reduced use of the wrist during recovery.

Pain Management

Pain and swelling can be managed with over-the-counter medications such as ibuprofen or paracetamol. These anti-inflammatory drugs help alleviate discomfort and improve the ability to perform basic activities during the healing process.

Corticosteroid Injections

For cases of persistent inflammation that do not respond to standard medications, corticosteroid injections may be administered. These injections target the affected area directly, reducing inflammation and providing significant pain relief in a short period.

Surgical Treatment

Ligament Repair or Reconstruction

Torn ligaments are surgically repaired by suturing the damaged ends or reconstructing them with grafts from other tissues, such as tendons. This procedure restores wrist stability and functionality, though recovery may require extensive rehabilitation.

Wrist Arthroscopy

This minimally invasive procedure involves inserting a small camera into the wrist joint to visualise and address the injury. Ligament repairs or removal of damaged tissue can be performed during arthroscopy, minimising trauma to surrounding structures and reducing recovery time.

Fusion or Proximal Row Carpectomy

In severe cases of chronic instability or arthritis, stabilisation procedures such as bone fusion or proximal row carpectomy are performed. Fusion involves permanently joining wrist bones to reduce pain and improve stability, while carpectomy removes damaged bones to preserve some range of motion. Both procedures are typically considered when other treatments have been unsuccessful.

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Prevention and Management

Although not all wrist ligament injuries can be prevented, certain precautions can reduce the risk. Using wrist guards during high-impact sports or activities provides protection against injury. Maintaining proper technique during repetitive tasks or physical activities helps minimise undue stress on the wrist ligaments. Regular exercises to strengthen and improve wrist flexibility can further enhance stability and reduce vulnerability to injuries. Prompt medical attention for pain or instability is necessary to prevent the injury from worsening and to ensure timely management.

Frequently Asked Questions

What are the long-term effects of untreated wrist ligament injuries?

Without treatment, wrist ligament injuries can result in chronic instability, limited range of motion, ongoing pain, and degenerative conditions such as arthritis.

Can wrist ligament injuries recur after treatment?

Yes, recurrence is possible, especially if rehabilitation is incomplete or if high-risk activities are resumed without appropriate precautions.

Can ligament injuries affect other parts of the wrist or hand?

Yes, injuries can lead to overcompensation by other muscles and joints, potentially causing additional pain, strain, or dysfunction in the wrist or hand.

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Dr Jacqueline Tan

MBBS (SG)

MRCS (Edin)

MMed (Surgery)

FAMS (Hand Surgery)

Dr. Jacqueline Tan is a hand surgeon in Singapore with over 18 years of experience in managing hand, wrist, and nerve conditions. Formerly the Head of Department of Hand and Reconstructive Microsurgery at Singapore General Hospital, she has continued to contribute significantly to her profession.

  • Director of Micro-Reconstruction Service and the Director of Peripheral Nerve and Paralytic Upper Limb Service
  • Upon the completion of her training as a hand surgeon in Singapore, Dr Tan was awarded the prestigious Health Manpower Development Plan scholarship by the Ministry of Health (MOH).
  • Completed a one-year advanced fellowship in Taiwan under the tutelage of internationally-acclaimed Hand and Orthopedic Microsurgeon – Professor Yuan-Kun Tu
  • Dr Tan’s field of expertise is in early and late brachial plexus reconstruction, peripheral nerve disorders, reconstructive microsurgery of the extremities and wrist disorders.

Widely Published
In hand surgery

Active In
Academic Teaching

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    Mt Elizabeth Novena Hospital

    38 Irrawaddy Road #07-42
    Singapore 329563

    Weekdays: 8:30am – 5:30pm
    Saturdays: 8:30am – 12:30pm
    Sundays & Public Holidays: Closed

    +65 9230 9554