Brief Outline of Wrist Dislocation
Most dislocations of the wrist involve the lunate bone, though other bones may also be involved. When a bone is dislocated, it no longer properly makes contact with adjoining bones. The injury affects the soft tissue surrounding the region of dislocation, including muscles, nerves, tendons, ligaments, and blood vessels.
Anatomy and physiology
The wrist consists of a series of radio-carpal and intercarpal articulations. However, most wrist movement occurs at the radio-carpal joint, an ellipsoid joint. The distal surface of the radius and articular disc articulates with the proximal row of carpals, which are the scaphoid, lunate and triquestral (triquetrum). Movements are in combination with the intercarpal joints. The intercarpal joints are a series of plane joints, which have articulations between the two carpal rows (midcarpal joint), plus articulations between each bone of the proximal carpal row and of the distal carpal row. The distal radio-ulnar joint is immediately adjacent to the radio-carpal joint. A cartilaginous disc separates the distal ulna and radius from the lunate and triquetral bones. An elaborate complex of ligaments holds these bones together and allows for their proper coordination. Dorsal ligaments of the wrist are weaker and more likely to be involved in dislocations.
Cause of Wrist Dislocation
Complication of a severe wrist sprain. Hard fall on an outstretched hand. Congenital abnormality, including malformed joint surfaces.
Signs and symptoms
Loss of hand and wrist dislocation are largely unpredictable, with some cases of full recovery and restoration of movement. Complications however may restrict motion of the wrist and produce ongoing pain, joint stiffness, discomfort, and impaired flexibility and movement. Arthritis may develop in the injured region.
Treatment
- Immobilisation using Fibreglass cast
- Ice
- Oral Medicines
- Physiotherapy
- Injection
Rehabilitation and prevention
Exercises designed to strengthen wrist muscles and ligaments will help prevent re-injury. Protection of the wrist during athletics, with gloves, wrist guards or taping may also offer some protection against wrist dislocations.
Long-term prognosis
Prognosis depends on the severity of the dislocation and any attendant complications, including fracture. Proper early treatment and appropriate rehabilitation leads to full recovery in most cases.