Joe A Shaw PA-C - 4/29/2009

Question
Hey there,  I just went to the doctor today about a wrist problem; about a year ago I landed on it flat palmed.  At the time, I thought I only sprained it; after about a week, it no longer hurt, though it always seemed to have a little less motion than it should.  Then, about five months ago, I was playing with my children and hurt it all over again.  After that, the pain never quite went away and the range of motion got worse.  But since our insurance got played with, I didn't go because I was afraid we could afford it... finally, though, I did.  The doctor I went to said that a major ligament looked torn; there are bones on one side crowded too close together now, as well as a chip missing off the top of the ulna.  He said nothing can be done to repair this, and my only answer is to wear a brace and take anti-inflammatories and someday a potential wrist-fusion.  I'm... not convinced.  Should I seek a second opinion?  Any suggestions at all?

Answer
Stephanie,
You should have an MRI done and/or probably an arthrogram (where they inject dye into wrist compartment and take a special xray to see if any fluid leaks out into other compartments) Although as we age > 45-50 yrs old we will have degenerative changes and 40-45% of asymptomatic wrists can have compartment leakage. But you need to have it coorelate w physical exam ie having pain where the inury or leakage is seen.
He may be talking about the TFCC ligament. It can tear and most likely should be repaired. Sounds like you kind of jammed your wrist bones(carpals)into the joint surface of your forearm bone (ulnar) called a compression fx/injury. I would get a second opinion from a hand ortho. If not a TFCC tear, then there probably is not a lot of harm in treating conservatively, if little pain or tolerable pain.

The Active wrist wrap can work well as it can be made cold or warm along w biofreeze gel and Advil..it's worth a try before you try more expensive things
http://www.carpal-tunnel-symptoms.com/ice-wraps.html
http://www.carpal-tunnel-symptoms.com/pain-relief-creams.html