Wrist Injuries: Symptoms, Treatment, and Recovery Insights

Regarding wrist injuries?

Hello Doctor: My wrist was injured on June 1 (bent backward due to external force).
I went to an orthopedic clinic where X-rays showed no bone issues.
An ultrasound diagnosis indicated ligament laxity of the scaphoid and a triangular fibrocartilage injury (it was not clearly stated whether it was cartilage or ligament).
The symptoms include pain when lightly pressing the junction of the middle and ring fingers with the wrist, and a feeling of weakness when gripping.
So far, I have undergone 12 sessions of physical therapy (infrared, electrical stimulation, laser) and have also seen a traditional Chinese medicine practitioner, receiving 9 sessions of electroacupuncture.
There was improvement during the process, with about 70% recovery around the two-month mark, but there has been almost no progress from two months to now, nearly three months later.
I still hesitate to lift heavy objects.
Currently, the symptoms include slight soreness and a feeling of stiffness at the junction of the ring finger and wrist when at rest; it doesn't hurt with general pressure, but deep pressure is uncomfortable.
My grip strength is still not very strong, and the soreness and stiffness become more pronounced during activities that require some force, such as brushing my teeth, using dental floss, or pressing the Ctrl+V keys on the keyboard with my pinky and index fingers during larger movements.
I would like to ask the doctor the following questions: 1.
Will my symptoms improve on their own over time with just heat therapy, or are there specific exercises or rehabilitation treatments that could help? 2.
If it is a ligament injury, is it expected to heal in about three months, or could the combined triangular fibrocartilage injury prolong recovery? 3.
Since the beginning, my doctor has advised using a soft wrist brace that wraps around the wrist and thumb; would a more rigid splint be necessary for faster recovery? 4.
Should I go to a major hospital for an MRI to assess the extent of ligament or cartilage damage? If I need to see a doctor, should it be an orthopedic specialist or a rehabilitation specialist? If it's an orthopedic doctor, should I specifically seek one who specializes in hand injuries? Thank you for your assistance!

Ben, 30~39 year old female. Ask Date: 2021/08/27

Dr. Zhan Xian reply Orthopedics

Hello Ben, based on the symptoms you described, you should visit a major hospital's orthopedic department for an examination.
A hand surgery specialist would also be appropriate.

Reply Date: 2021/08/27

More Info

Hello! Thank you for sharing your concerns regarding your wrist injury. Based on your description, it seems you are dealing with a complex situation involving potential ligament laxity and possible triangular fibrocartilage complex (TFCC) injury. Let’s address your questions one by one.

1. Will my symptoms improve over time with heat therapy, or do I need specific exercises or rehabilitation?
While some wrist injuries can improve with time and conservative treatment, it’s essential to actively engage in rehabilitation. Heat therapy can help alleviate pain and improve circulation, but it should be complemented with specific exercises to strengthen the wrist and improve range of motion. Physical therapy often includes exercises that focus on wrist stability, flexibility, and strength. A physical therapist can tailor a program to your needs, which may include stretching, strengthening, and functional exercises to help you regain full function.

2. If it’s a ligament injury, will it heal in about three months, or could a TFCC injury prolong recovery?
Ligament injuries can vary significantly in healing time depending on the severity of the injury. Mild sprains may heal within a few weeks, while more severe injuries, especially those involving the TFCC, can take several months. The TFCC is crucial for wrist stability and can indeed prolong recovery if injured. If you have not seen significant improvement after three months, it may indicate that the injury is more complex than initially thought, and further evaluation may be necessary.

3. Should I switch from a soft wrist brace to a more rigid splint for faster recovery?
The type of brace or splint you use can significantly affect your recovery. A soft brace provides some support but may not limit movement enough to allow for proper healing of more severe injuries. A more rigid splint can immobilize the wrist better, reducing strain on the injured ligaments and allowing them to heal. However, it’s essential to balance immobilization with the need for movement to prevent stiffness. Consulting with a healthcare professional about the best type of support for your specific injury is advisable.

4. Should I get an MRI to assess the extent of ligament or cartilage damage, and which specialist should I see?
An MRI is a valuable tool for assessing soft tissue injuries, including ligaments and cartilage. It can provide detailed images that help determine the extent of your injury and guide treatment decisions. If you suspect a significant injury, visiting an orthopedic specialist, particularly one who specializes in hand and wrist injuries, would be beneficial. They can evaluate your condition, recommend imaging if necessary, and develop a comprehensive treatment plan.

In summary, while some wrist injuries can improve over time, active rehabilitation is crucial for optimal recovery. If your symptoms persist or worsen, further evaluation through imaging and consultation with a specialist is warranted. Remember, every injury is unique, and a tailored approach to your rehabilitation will yield the best results. Don’t hesitate to seek further medical advice if you have concerns about your recovery process. Best wishes for your healing journey!

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