There are numerous soft tissue structures that provide stability to the various joints of the wrist including the volar and dorsal extrinsic ligaments as well as the ulnar and radial collateral ligaments. Intrinsic ligaments such as proximal and distal interosseous ligaments as well as midcarpal ligaments all provide stability to the wrist. An injury to any of these is considered a sprain. There are different grades of sprains:

• Grade 1- Mildest. Stretched soft tissue, but not torn
• Grade 2- Partial tearing of soft tissue
• Grade 3- Complete tearing or rupture of soft tissue. May require surgery to repair

• Wrist pain or tenderness
• An audible popping sound during injury
• Clicking or popping during motion
• Swelling or bruising at site of injury
• Decreased range of motion or strength

• It is difficult to fully prevent wrist sprains, as these often occur due to sudden injury, but risk can be reduced by:
  • Maintaining strong muscles and muscle balance
  • Stretching before using your hands in an activity
  • Avoid repetitive movements

• X-rays are usually done to ensure there are no fractures
• MRI may be done if full ligament tear is suspected
• Arthrogram, which is a special MRI using injectable dye, to determine if there are any ligament tears
• Arthroscopy, which is a minimally invasive surgical procedure and uses a camera to look around the wrist to identify suspected ligament tears. These tears can then be fixed during this procedure as well. This is considered the “gold standard” of diagnosis.

• Hand therapy is initiated to address range of motion, swelling, and strength
• Custom fabricated immobilization splints, dynamic splints to improve range of motion
• Edema management via compression garments, coban wrapping, KT taping, manual edema mobilization
• Range of motion exercises
• Wrist stabilization exercises
• Strengthening following improvement in range of motion and swelling
• Pin care, wound care, or scar management if post op