Ligamentous injuries of the wrist in the athlete

Wrist and Hand Injuries in Baseball

Pitching, catching, and base-running may predispose professional baseball players to injury-particularly in the hand and wrist. In this study, we outline the diagnosis, management, and rehabilitation of commonly encountered injuries among these high-level athletes. Wrist injuries discussed include hook of hamate fractures, extensor carpi ulnaris tendon disorders, scapholunate instability, and triangular fibrocartilage complex tears. Hand injuries discussed include thumb ulnar collateral ligament injury, flexor tendon pulley rupture, hypothenar hammer syndrome, and blisters.

Management of carpal instability in athletes

Hand and wrist injuries are common in most athletic events and sports. Carpal fractures and ligamentous injuries are common in athletes and require physicians, trainers, and therapists who treat and diagnosis these injuries to have an understanding of the carpal bone anatomy and vascularity along with the potential for progression to instability. Research is still needed to further investigate the optimal treatments of all carpal injuries in athletes along with designing new means to prevent these injuries.

Tenodesis of the extensor carpi ulnaris for chronic, post-traumatic lunotriquetral instability

We describe a technique of soft-tissue reconstruction which is effective for the treatment of chronic lunotriquetral instability. Part of extensor carpi ulnaris is harvested with its distal attachment preserved. It is passed through two drill holes in the triquetrum and sutured to itself. This stabilises the ulnar side of the wrist.

We have reviewed 46 patients who underwent this procedure for post-traumatic lunotriquetral instability with clinical signs suggestive of ulnar-sided carpal instability. Standard radiographs were normal. All patients had pre-operative arthroscopy of the wrist at which dynamic lunotriquetral instability was demonstrated. A clinical rating system for the wrist by the Mayo clinic was used to measure the outcome. In 19 patients the result was excellent, in ten good, in 11 satisfactory and in six poor. On questioning, 40 (87%) patients said that surgery had substantially improved the condition and that they would recommend the operation. However, six (13%) were unhappy with the outcome and would not undergo the procedure again for a similar problem. There were six complications, five of which related to pisotriquetral problems. The mean follow-up was 39.1 months (6 to 100). We believe that tenodesis of extensor carpi ulnaris is a very satisfactory procedure for isolated, chronic post-traumatic lunotriquetral instability in selected patients. In those with associated pathology, the symptoms were improved, but the results were less predictable.

The Wrist: Common Injuries and Management

Primary care physicians not only have an important role in the diagnosis and initial treatment of wrist injuries, but also play a key role in the education of families about prevention. Children and adolescents are often competitive in sports throughout the year. Periods of rest can be important in prevention of overuse injuries in the very active, developing athlete. Protective gear such as wrist guards, used during activities such as inline skating and snowboarding, has been shown to prevent acute injuries that often require surgery or lead to prolonged disability [84,85].A primary care physician will often be the first health care provider to assess most wrist complaints. The intent of this article is to familiarize the primary care physician with the most common wrist injuries in active people, and to demonstrate that many injuries can have poor outcomes if unrecognized. It is important to have good clinical knowledge of the functional anatomy of the wrist in order to maximize the information gathered on examination and to narrow one's differential diagnosis. The athlete's sport and desires regarding return to play, and the impact of the timing of injury management on his or her further participation in sport are important to consider. A highly active person may be referred to a musculoskeletal specialist for advanced testing or surgical repair earlier in the evaluation of certain injuries than a less active one. Armed with good clinical knowledge of anatomy and an understanding of common wrist injuries,primary care physicians can successfully manage many wrist complaints.

Osteoarthritis in Other Joints (Hip, Elbow, Foot, Ankle, Toes, Wrist) after Sports Injuries

Osteoarthritis of nonknee joints, although less common than knee osteoarthritis, remains a significant and disabling condition for many present and former athletes. These injuries can be caused by repeated loads or following a specific traumatic event. The resulting pain and loss of motion can limit function and ability. Arthroscopic techniques in many cases enable surgeons to symptomatically treat limitations of range of motion and pain, prolonging active careers. Joint replacement remains the ultimate solution for hip osteoarthritis, and may be a viable option in ankle osteoarthritis.

Athletic injuries of the wrist and hand. Part I: traumatic injuries of the wrist

Hand and wrist injuries in sports are some of the most common injuries reported. This review discusses briefly the causes of hand and wrist injuries in sports and discusses pertinent biomechanical findings regarding the range of motion required in different sports activities. The bulk of the review discusses specific traumatic and overuse injuries to the hand and wrist commonly seen in the athlete. Emphasis is placed on problematic traumatic injuries such as carpal scaphoid fractures and hook of the hamate fractures, as well as ligament injuries to the wrist with regard to diagnosis, treatment, and return to athletic competition.

Acute wrist injuries in the athlete

The athlete represents a special population in which injuries can occur either from a single acute traumatic event or as part of a continuum of overuse that leads to osseous or soft tissue failure. The spectrum of overuse with superimposed acute trauma makes the evaluation of the upper extremity in the competitive athlete more challenging. The expectation of this population for quick, full, painless recovery, coupled with the desire to return to the sport that caused the injury, makes the treatment difficult as well. This article will discuss athletic injuries of the forearm and wrist with an emphasis on evaluation, treatment, and criteria for return to play.