Wrist ligament injuries
After a bad sprain to the wrist x-rays can sometimes look normal, but there may be a significant ligament injury. The commonest wrist ligament injury is to the scapho-lunate ligament, but others can also be injured. If this ligament ruptures fully it can cause ongoing pain and clicking in the wrist. If it is left untreated it can again set up a predictable pattern of arthritis is the wrist, which may lead to a stiff and painful wrist in later life. This often requires extensive surgery to try to improve the symptoms.
The shock absorbing pad on the inside of the wrist is called the TFCC (triangular fibro-cartilaginous complex). This also has a role in stabilising the two bones in the forearm: the radius and the ulna. If the TFCC is injured it can cause these bones to be unstable, or it can cause pain on the inside of the wrist.
Mr Wharton uses keyhole (arthroscopic) techniques to look around the wrist and identify ligament or TFCC problems. Some of these can be easily treated with keyhole techniques, but some require a mini-open or open approach. This surgery is undertaken as a day case with either general (asleep) or regional (nerve block around the shoulder) anaesthetic. . A plaster is sometimes applied for six weeks after the surgery, and then the patient is encouraged to move the wrist under the supervision of a hand therapist. The hand should be elevated for five days after surgery and the wound must be kept clean and dry for two weeks.