[ Ссылка ] - As the hand and wrist are extremely delicate parts of the body, the ligaments that ensure the bones stay in the right position are very important for movement. Should these ligaments become disrupted or moved out of place, pain, and function loss can occur, as well as the premature development of arthritis. Most likely, these injuries occur when the patient falls on the outstretched wrist, which is often seen in athletic injuries. Because of the non-bony nature of ligaments, it is easy to miss tears to them on a standard X-ray, which is why it is important for patients suffering from them to see a specialist for more effective diagnosis and treatment so that the injury is not misdiagnosed.

Of the ligaments in the wrist, it is most common to see injury to the scapholunate ligament, which connects the scaphoid and the lunate, and the lunotriqutral ligament, which serves the same purpose for the lunate and triquetrum bones.

The aforementioned unreliability of traditional x-rays means that a more indicative test, the MR-Arthrogram, is generally necessary to determine injury to these tendons. The radiocarpal joint in injected with dye, and if the dye flows from there to the midcarpal joint, then a torn ligament is very likely. Even though an image like this will indicate injury in about 70% of cases, even a normal MRA does not necessarily ensure that the ligaments are not torn.

If the tear to the ligaments are only partial, then a four to six week regimen of splinting may be effective in allowing sufficient immobilization for healing. Should this prove ineffective, and if the injury is caught in time, then there is a three-month window in which an arthroscopic procedure may allow the injury to be corrected, and this procedure is found to be effective in 80% of cases.

Often, however, the damage to the ligaments may be more substantial, such that they cannot be reattached to the bone. If this is the case, a small vacuum-like tool is used to clean up the torn edges and scar tissue on the ligament, after which time tiny metal pins are installed in the wrist to hold the bones together and allow the ligaments to rebuild themselves and develop some scar tissue.

An eight-week period of immobilization is necessary after this type of procedure, facilitated with a brace. After eight weeks, surgery is undergone to remove the pins, and then three months of therapy are necessary to return use of the hand of full function. If diagnosed in a reasonable amount of time, this minimally invasive procedure should prove effective in reducing symptoms and returning to full function.


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