What are the treatment options for fallen on-hand wrist pain?

Question

Hi doctor,

I have fallen on hand wrist, and my x-ray report says that borderline or mildly enlarged proximal scapholunate interval (3 to 4 mm) and overall maintained joint spaces. No fracture, dislocation, or aggressive osseous lesion. Dorsal hand soft tissue edema, centered at the second to fifth metacarpal shafts, nonspecific, presumed soft tissue contusions. Could you please tell me if there is anything to worry about?

Answer 1

Hello,

Welcome to icliniq.com.

The available information shows that the ligaments holding the two bones in the proximal row of the wrist are stretched or partially torn (as x-ray predicts a gap of 2 to 3 mm). Therefore, I suggest you have a clinical test known as the Watson test, in addition to a detailed assessment of the injured limb and hand, which is necessary to decide further course of action, like whether there is intercarpal instability or the need for an MRI (magnetic resonance imaging). Coming to the treatment part, I suggest you immobilization in a splint, limb elevation, and ice pack application would suffice in the initial period. Then, based on further detailed assessment I suggest following course of management:

1) Continue immobilization for four to six weeks.

2) Immediate repair of the ligament if diagnosed by MRI and supported by the clinical test of instability.

3) Tear reconstruction if repair is not amenable due to anatomical constraints.