Wrist and Thumb Sprains

Stretching and tearing of the ligaments that hold bones together is known as a sprain. Catching oneself on an outstretched hand while falling forward often causes sprains of the ligaments that connect the bones within the wrist joint or in the main ligament responsible for grasping and pinching motions (the ulnar collateral ligament). Wrist and thumb sprains are a common injury in sports medicine, especially in skiing, skateboarding, rollerblading, and other sports in which falling forward often occurs. You can reduce your risk of sprains by wearing wrist guards while engaging in these activities, and by using caution in wet or icy conditions.

Symptoms of a sprain include swelling, tenderness, bruising, a popping sensation within the wrist, an inability to grasp objects, and warmth in the skin over the injured area. Sprains are categorized into three grades, depending on the severity of the sprain:

1. In a Grade 1 sprain, the ligaments are overstretched, but not torn.
2. A Grade 2 sprain occurs when some of the ligaments of the wrist are torn, resulting in some loss of function.
3. In a Grade 3 sprain, the ligament is torn all the way through. When the ligament tears away from the bone, it may also break off bone fragments.

Diagnosis of a sprain will include a thorough examination of the wrist and arm, a complete medical history, and details of the accident causing the sprain. In some cases, an X-ray may be necessary to determine whether a fracture has occurred.

Mild sprains can be treated by RICE (rest, ice, compression, and elevation). The injured wrist should be rested for at least 48 hours. Indirect application of ice (use a towel between your skin and the ice) for 20 minute periods can help reduce the swelling. Compression with an elastic bandage, elevation above the level of your heart, and anti-inflammatory medications such as ibuprofen will also assist in reducing the swelling and allowing the injury to heal. More severe sprains may require immobilization in a splint or surgery to repair the torn ligament. Immobilization in a cast for 6-8 weeks to allow the injury to heal will then be necessary.