Wrist Bone Protrusion: Causes, Treatment, and Recovery

Wrist bone protrusion?

The middle finger of my left hand was forcefully pulled, raising my entire arm.
Subsequently, my wrist was pressed down, resulting in complete swelling at the wrist.
Visually, it appears that the bone on the outer side of the wrist has been displaced and is now higher (definitely higher than before the injury), with swelling of about 0.5-1 cm.
I initially went for an X-ray, but the doctor visually assessed that the bone was fine and advised me to take anti-inflammatory medication without any further treatment.
When I inquired about the protruding bone area, he did not respond directly, only saying to take painkillers if it hurts in the future.
At its worst, my entire arm felt weak, all five fingers were swollen and painful, and I experienced pain even while sleeping, which lasted for about two weeks.
I took anti-inflammatory medication, and now, a month later, my fingers, palm, and wrist still feel sore and numb, and my entire hand feels slightly weak, unable to exert full strength.
The area where the bone protrudes remains elevated (about 0.5 cm) and is still swollen and very painful.
I also experience sharp pain in my entire arm with slight pulling, and there is some discomfort in my upper arm as well.
1.
Should I continue taking anti-inflammatory medication and then proceed with rehabilitation later?
2.
If there is indeed a slight bone displacement, how should it be managed? Is reduction necessary for a minor displacement? Could the prolonged pain be due to a slight misalignment of the bone? If I delay treatment, even if the swelling completely subsides, will the elevated bone position lead to future complications?
3.
If the bone is truly not displaced, will the elevated area return to normal once the inflammation resolves? If it does not subside, what could be the underlying issue?
4.
Given the extent of my injury, how long should I expect to rest?
Thank you.

Peggy, 30~39 year old female. Ask Date: 2022/09/29

Dr. Chen Yongxue reply Orthopedics

Hello, based on your letter, the injury seems to be quite severe.
If there is a bone displacement, it would result in immobility and abnormal pain.
Personally, I believe the likelihood of that is low; it could possibly be a joint capsule injury leading to joint effusion.
Please visit an orthopedic outpatient clinic for further examination.
Thank you.

Reply Date: 2022/09/29

More Info

Understanding wrist bone protrusion, particularly after an injury, involves recognizing the underlying causes, treatment options, and recovery expectations. Based on your description, it seems you have experienced a significant strain or injury to your wrist, which has resulted in swelling, pain, and a noticeable protrusion of the bone.

Causes of Wrist Bone Protrusion
The protrusion you are observing could be due to several factors:
1. Soft Tissue Injury: The ligaments and tendons around the wrist may have been stretched or torn, leading to inflammation and swelling. This can sometimes make the bones appear more prominent.

2. Bone Displacement: Although your X-ray did not show any fractures, it is possible that there is a minor displacement of the bones in the wrist joint that is not visible on standard X-rays.

3. Joint Effusion: Swelling in the joint due to fluid accumulation can also contribute to the appearance of a protruding bone.

4. Tendon or Ligament Damage: Damage to the structures supporting the wrist can lead to instability, which may cause the bones to shift slightly.

Treatment Options
1. Medication: Since you have been prescribed anti-inflammatory medication, it is essential to continue taking it as directed. This will help manage pain and reduce inflammation.

2. Rest and Ice: Resting the wrist and applying ice can help decrease swelling. Avoid activities that exacerbate the pain.

3. Physical Therapy: Once the acute pain subsides, physical therapy can be beneficial. A therapist can guide you through exercises to strengthen the wrist and improve range of motion.

4. Follow-Up Imaging: If symptoms persist, consider requesting further imaging, such as an MRI, to assess soft tissue injuries or subtle bone issues that may not be visible on X-rays.

Recovery Expectations
1. Duration of Recovery: The recovery time can vary significantly based on the severity of the injury. Generally, soft tissue injuries may take several weeks to heal, while more severe injuries could take months.

2. Protrusion and Pain: If the bone remains protruded after the swelling has decreased, it may indicate a need for further evaluation. Persistent pain and protrusion could suggest an underlying issue that may require intervention.

3. Potential for Long-Term Issues: If there is a small displacement or misalignment that is not addressed, it could lead to chronic pain or instability in the wrist. This could potentially result in arthritis or other long-term complications.

Questions Addressed
1. Continued Medication and Rehabilitation: Yes, continuing anti-inflammatory medication and engaging in rehabilitation is advisable. It is crucial to follow your doctor's recommendations regarding rest and activity modification.

2. Handling Minor Displacement: If there is a minor displacement, it may not always require surgical intervention. However, if the pain persists, a consultation with an orthopedic specialist may be warranted to discuss potential options for realignment or further treatment.

3. Bone Protrusion Resolution: If the bone is not displaced, the protrusion may reduce as swelling decreases. However, if it remains, further evaluation is necessary to rule out other issues.

4. Rest Duration: The duration of rest will depend on the severity of your symptoms. Generally, a few weeks of rest is recommended, but this should be tailored to your specific situation and guided by your healthcare provider.

In summary, while your initial assessment did not indicate a fracture, the ongoing symptoms suggest that further evaluation may be necessary. It is crucial to monitor your symptoms closely and maintain open communication with your healthcare provider to ensure proper management and recovery. If the protrusion and pain persist, seeking a second opinion or further imaging may be beneficial to rule out any underlying issues.

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