Dislocated Wrist

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The wrist contains a total of three joints – this makes the wrist much more stable, similar to having only one joint. The joints also give your wrist and hand a wide range of movement. Furthermore, the wrist joints let your wrist move your hand up and down, for example, when lifting your hand to wave around.

These joints give you the ability to bend your wrist forwards and backwards, side to side, and to rotate your entire hand. The three wrist joints are known as the radiocarpal joint, ulnocarpal joint, and distal radioulnar joint:

  • Radiocarpal joint – This is where the radius (the thicker forearm bone) connects the bottom row of your wrist bones, which are the scaphoid, lunate, and triquetrum bones. This joint is mainly on the thumb side of your wrist.
  • Ulnocarpal joint – This is the joint between the ulna (the thinner forearm bone) and the lunate and triquetrum wrist bones. The ulnocarpal joint is located on the ‘pinky’ (little finger) side of your wrist.
  • Distal radioulnar joint – This joint is in the wrist but does not include the wrist bones. It connects the bottom ends of the radius and ulna.

A dislocated wrist (also known as carpal dislocation) is an injury where any of the eight carpal bones that make up most of the wrist is displaced or dislocated in any way. These eight carpal bones are known as the hamate, capitate, pisiform, trapezoid, trapezium, lunate, triquetrum, and scaphoid. Wrist dislocations are normally the result of direct trauma or any force on the wrist that is enough to cause dislocation. In addition, there are a few different types of wrist dislocations, such as:

  • Galeazzi fracture – A Galeazzi fracture involves remote fractures at the far end and middle-third of the large bone of the forearm. It also includes dislocation of the joint where the two forearm bones meet, causing instability of the forearm axis joint.
  • Monteggia fracture – A Monteggia fracture refers to a dislocation of the radial head in association with a fracture of the ulna (one of the bones of the forearm) at the elbow joint.
  • Perilunate dislocation – Perilunate dislocations (or ‘lunate dislocations’) are injuries to the small bones of the wrist. It usually involves the lunate bone and the three ligaments around it.
  • Anterior lunate dislocation – This occurs when the lunate bone rotates while the other wrist bones remain in place.

Causes & Symptoms of a Dislocated Wrist

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Wrist dislocations and wrist sprains share the same types of causes. However, wrist dislocations are much more serious than a sprain – when the wrist is dislocated, one or more of the bones inside the wrist has moved out of alignment and will need to be moved back into place.

Certain causes linked to a dislocated wrist include the following:

  • Falls on an outstretched hand – Supporting yourself from a fall by landing on an outstretched hand is a common reflex during a loss of balance from slips and falls. Wrist dislocations from falls may occur in accidents, such as slipping over ice, wet surfaces, or falling from stairs or heights.
  • Physical combat – Engaging in physical combat can increase the likeliness of dislocating your wrist. This is common in sports activities such as wrestling.
  • Sports injuries – Injuries from playing certain sporting events can cause bending or twisting of a wrist, resulting in either tearing or dislocation.

Certain symptoms that are associated with a dislocated wrist include:

  • Painful sensation – There will be a sharp pain being felt on your injured wrist. The pain may also increase in intensity when gripping or lifting with the hand and may be painful until complete healing occurs. Hand twisting activities, such as opening a jar or doorknob can also be painful.
  • Swelling – The wrist may appear swollen alongside its dislocation. Swelling may occur due to the collection of fluid in the joint and tissue spaces of the injured area.
  • Joint weakness – Reduced grip and pinch strength with a general feeling of weakness in the dislocated wrist may occur in moderate to severe wrist dislocations.
  • Numbness – Numbness in one or more fingers may be experienced in cases where a wrist bone dislocates and presses on one or more nerves in the wrist.
  • Warmth to the touch – A feeling of warmth over the dislocated wrist may be present due to increased blood flow to the area.
  • Bruising – A bruise (contusion) may form on the skin over the wrist due to rupture of blood vessels under the skin and leaking of blood into the tissue spaces. This may often occur if you experience a wrist sprain.

Who gets a Dislocated Wrist?

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Several risk factors can cause dislocation of the wrist. Some of these factors include:

  • Sports – Playing sports such as tennis may injure the wrist ligaments either by sudden force or by repeated trauma. Weightlifting is another sport that may sprain or dislocate the wrist when it bends beyond its normal range of motion. Wrist tearing in weightlifting may occur suddenly or over time due to repeated stress on the ligaments.
  • Motor vehicle accidents – Forceful bending of the wrist in a car or motorcycle accident can lead to dislocation. Direct or indirect trauma from the deployment of an airbag may also injure the wrist’s ligaments in a car accident.
  • Machine operating – manual labour jobs, especially those with machine operating activities can place you at increased risk of dislocating your wrist.

How Does a Dislocated Wrist Affect You? How Serious is it?

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Usually, the regular recovery estimate of a dislocated wrist takes 2-3 months to heal. However, if you need surgery, it may take six months to a year to fully recover. Surgical treatment for a dislocated wrist is performed by realigning your wrist bones and / or repairing any torn ligaments. This is often done using pins or screws to hold everything in place. All surgeries come with the potential for complications, including:

  • Infections
  • Nerve or blood vessel damage
  • Persistent wrist pain
  • Longer-term stiffness
  • Blood clots

Recommended Treatment & Rehabilitation for a Dislocated Wrist

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In order to get a clear diagnosis of a dislocated wrist, your physician will likely perform a regular three-step diagnostic process, which involves a complete medical history, physical exam, and additional imaging tests.

In this routine, first your physician will ask you for a description of your symptoms, how they started, and what triggered them. Next, he or she will examine your wrist and forearm for any dislocation or discoloration.

Your doctor may also manipulate your wrist or ask you to perform certain hand or wrist movements. Further imaging tests may be ordered to increase the chance of getting a clearer diagnosis for your dislocated wrist. Some of these include:

  • Computed Tomography (CT) scan – CT scans can uncover wrist fractures that X-rays usually miss. Injuries to soft tissues and blood vessels can be seen on CT scans.
  • Magnetic Resonance Imaging (MRI) – Using radio waves and a powerful magnet to produce detailed images of bone and soft tissues, MRIs are much more sensitive than X-rays and can identify very small fractures and ligament injuries.

After a diagnosis has been done, physiotherapy may be further advised. A physiotherapist will work with you following a dislocated wrist to help regain regular wrist motion, strength, and function, and will provide education and training to help you prevent future fractures. Therefore, while your bone heals, your arm will be equipped with a cast or a sling to keep it still and promote healing.

During that time, it is important to ensure that the arm does not get too stiff, weak, or swollen. Depending on the amount of activity that your injured wrist can withstand, your physiotherapist will prescribe gentle exercises to keep your shoulder, elbow, and fingers moving while you’re in the cast or sling.

After your cast is removed, your wrist will most likely feel very stiff, and your arm will feel weaker. Therefore, your therapist will examine your wrist, and design a treatment plan specific to your condition and goals to improve its function and restore strength to your arm. Your treatment will include:

  • Pain management – Your physiotherapist will help you identify and avoid painful movements and show you how to correct abnormal postures to reduce stress on the wrist. He or she will likely recommend resting the wrist short-term and applying ice to the area to help alleviate the pain. Your therapist may also apply a wrist brace to restrict wrist movement.
  • Manual therapy – Your physiotherapist may use manual techniques, such as gentle joint movements, soft-tissue massage, and wrist stretches to get your wrist moving properly.
  • Range-of-motion exercises – You will learn exercises and stretches to reduce stiffness and help your wrist, hand, and forearm begin to move properly.
  • Strengthening exercises – Your physiotherapist will determine which strengthening exercises are perfect for you, depending on your specific areas of weakness. Therefore, your therapist will design an individualized home-exercise program to meet your needs and goals.
  • Patient education – Depending on the activities you plan on continuing, your physiotherapist will teach you different ways to perform actions, while protecting your wrist and hand. For instance, keeping the wrist in a neutral position to reduce excessive force while performing repetitive tasks, and taking frequent breaks are ways to decrease your chances of reinjury.
      

Below are some examples of exercises for you to try. The exercises may be recommended to reduce symptoms linked to a dislocated wrist:

 

Wrist flexion and extension

Place your forearm on a table, with your hand and affected wrist extended beyond the table, palm down. Next, bend your wrist to move your hand upward and allow your hand to close into a fist, then lower your hand and allow your fingers to relax. Hold each position for 6 seconds, then repeat 8-12 times a day.

Wrist radial and ulnar deviation

Hold your affected hand out in front of you, palm down. Slowly bend your wrist as far as you can from side to side. Hold each position for 6 seconds, then repeat 8-12 times a day.

Hand flips

While seated, place your forearm and affected wrist on your thigh, palm down. Flip your hand over so the back of your hand rests on your thigh and your palm is up. Alternate between palm up and palm down while keeping your forearm on your thigh. Repeat this method 8-12 times a day.

Wrist extensor stretch

Extend your arm with the affected wrist in front of you and point your fingers toward the floor. With your other hand, gently bend your wrist farther until you feel a mild to moderate stretch in your forearm. Hold the stretch for at least 15-30 seconds, then repeat 2-4 times a day.

Wrist flexor stretch

Extend the arm with the affected wrist in front of you with your palm facing away from your body. Then, bend back your wrist, pointing your hand up toward the ceiling. With your other hand, gently bend your wrist farther until you feel a mild to moderate stretch in your forearm. Hold the stretch for at least 15-30 seconds. Repeat this exercise 2-4 times a day.

Alternative & Homeopathic Treatment for a Dislocated Wrist

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If you experience mild symptoms of a wrist dislocation, you may be able to ease your symptoms with a set of homeopathic treatments. Here are a few treatments for a dislocated wrist:

  • Take breaks from repetitive activities – Whether you are typing, playing guitar, or using a hand drill, try setting a timer beforehand for 15 minutes. When it goes off, stop what you’re doing and wiggle your fingers. Stretch your hands and move your wrists to help improve blood flow to these areas.
  • Rest – If you ever find yourself straining or forcing tasks such as writing, typing, or using a cash register, relax your grip or reduce the force you are using. Try using a soft-grip pen or tapping keys more lightly.
  • Stay warm – Keeping your wrist and hands warm can help with pain and stiffness. Consider wearing a fingerless glove or keeping hand warmers nearby.
  • Non-steroidal anti-inflammatory medications (NSAIDs) – such as ibuprofen, can help reduce further swelling and inflammation.

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