Introduction
The mobility of our wrist is based on a complicated construction of bones and ligaments, in which the two forearm bones ulna and radius as well as the eight carpal bones are involved. They are held together by a multitude of ligaments. If this ligamentous apparatus is injured, the result is a structural disorder in which the carpal bones move out of their natural position and tilt over each other.
In the long run, this leads to incorrect loading of the joint surfaces and thus to excessive wear of these. The result is wrist arthrosis. In an advanced stage, this is ultimately accompanied by pain, restricted movement and loss of strength.
Causes
The most common cause of wrist ligament injuries are accidents and falls. However, rheumatic diseases or metabolic disorders such as pseudo-gout can also be responsible for damage to the ligaments. Especially the fall on the outstretched hand or sudden strong twisting of the hand leads to torn ligaments.
The ligament connection between the scaphoid bone (Os scaphoideum) and the lunate bone (Os lunatum), the so-called SL ligament, is most frequently affected, as this is where the greatest force is exerted. As a result, the hand and moonbone rotate in opposite directions, the joint space increases and the joint surfaces wear out. Less frequently, however, the ligament between the lunar and triangular legs is affected. However, untreated arthrosis is also the consequence here.
Symptoms
Immediately after the accident there is shooting pain in the wrist, which is indistinguishable from a fracture of the wrist bones. These are accompanied by restrictions in movement, as the first row of wrists can no longer be moved effectively. At the same time the patient complains of a loss of strength in the wrist, which is caused by the malposition of the affected carpal bones.
If the injury remains untreated, a palpable swelling of the wrist may occur, which is caused by a proliferation of the joint mucosa (synovitis). Gradually, these complaints can subside, which is why the injury is often interpreted by the patient as a sprain (see: sprained wrist) and no subsequent treatment is given. This injury can then remain asymptomatic (without symptoms) for many years until the signs of wear exceed a critical point and wrist arthrosis becomes manifest.
Symptoms such as pain, loss of strength and restricted movement then reappear again. If the scapho-lunar ligament in the wrist is torn, the complaints are often not very pronounced at the beginning. The affected person initially only suffers from pain in certain situations, for example, when leaning on or grasping firmly.
This results in a sharp shooting pain in the wrist. Occasionally, the pain then decreases in the first weeks to months after the torn ligament. If a torn ligament in the wrist is left untreated, arthrosis develops over time due to incorrect strain. The pain increases with the arthrosis.