Wrist Joint Instabilities

Scapholunate Ligament Injury is a common diagnosis for a patient with radial sided wrist pain. Mechanism of injury is usually a fall on an outstretched hand with a hyperextended wrist in ulna deviation. This injury consists of a spectrum of clinical features which requires different forms of treatment.

The diagnosis for Scapholunate Ligament Injury is made by clinical examination, plain radiograph, MRI and diagnostic arthroscopy.

Treatment of this injury also ranges from non-operative lifestyle modification, analgesia and splinting to operative pinning, open ligamentous repair and fusion.

Triangular Fibrocartilage Complex (TFCC) Injury is a common diagnosis for patients who complain of ulnar sided wrist pain. TFCC is a complex ligamentous structure of the wrist which provide stability and a platform for movement to the wrist joint.

Some common causes of TFCC injury include:

• A fall onto the internally rotated (pronated) and hyperextended wrist
• Power-drill injuries in which the drill binds and rotates the wrist instead of the bit
• Distraction force applied to the volar forearm or wrist
• Distal radius fractures.

The diagnosis can be made with a plain radiograph, wrist arthrogram and MRIs. Treatment of this injury consists of conservative with splinting and analgesia to arthroscopic or open TFCC.