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Wrist Joint Instabilities

Scapholunate Ligament Injury

Scapholunate Ligament Injury is a common diagnosis in patients with radial-sided wrist pain. The injury usually results from falling on an outstretched hand with a hyperextended wrist in ulna deviation (pointing toward one's pinky finger). This injury manifests with various clinical features requiring different forms of treatment. Diagnoses are based on clinical examination, plain radiograph, MRI and diagnostic arthroscopy. Treatment options range from non-operative lifestyle modification, analgesia and splinting to operative pinning, open ligamentous repair and fusion.

Triangular Fibrocartilage complex (TFCC) Injuries

Triangular Fibrocartilage complex (TFCC) injury is a common diagnosis for individuals experiencing ulnar-sided wrist pain. TFCC, a complex ligamentous wrist structure, is a platform for movement and stabilises the joint.

Common causes of TFCC injury include:

  • Falling onto internally rotated (pronated) and hyperextended wrist;
  • Power-drill injuries in which the drill binds and rotates the wrist instead of the bit;
  • Distraction force applied to the volar forearm or wrist; and
  • Distal radius fractures.

Diagnoses can be made with plain radiographs, wrist arthrograms and MRIs. Treatment options range from conservative measures involving splinting and analgesia to arthroscopic or open procedures targeting the Triangular Fibrocartilage Complex (TFCC).

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