Skip to main content

Advertisement

Log in

Sports injuries of the wrist

  • Hand and Wrist (DA Osei, Section editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Sports injuries involving the hand and wrist are common and, as a result, many different practitioners (athletic trainers, physical therapists, primary care physicians, general orthopedic surgeons) will encounter these injuries. In addition to thorough evaluation, an understanding of typical pathologies seen in the athlete enhances diagnosis and facilitates appropriate, expedient management. These injuries are complex because they can be either acute traumatic or repetitive in origin and often involve both the bony skeleton and soft tissues. This article provides a review of athletic injuries to the wrist with particular focus on physical evaluation and management of the most common and challenging fractures and soft tissue injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Rettig AC. Athletic injuries of the wrist and hand. Part I: traumatic injuries of the wrist. Am J Sports Med. 2003;31:1038–48.

    PubMed  Google Scholar 

  2. • Swenson DM, Yard EE, Collins CL, et al. Epidemiology of US high school sports-related fractures, 2005–2009. Clin J Sport Med. 2010;20:293–9. Descriptive epidemiologic study of fractures occurring in high school athletes with specific analysis by sport. The authors found that fractures account for 10.1 % of all sports injuries. Fractures of the fingers, hands, and wrists accounted for 38.7 % of all such fractures, highlighting the prevalence of such injuries. They report that 26.9 % of all fractures require operative intervention. The authors highlight the economic costs associated with evaluation and treatment as well as the time out from sport, which averaged >3 weeks.

    Article  PubMed  Google Scholar 

  3. Gelberman RH, Wolock BS, Siegel DB. Fractures and non-unions of the carpal scaphoid. J Bone Joint Surg Am. 1989;71:1560–5.

    PubMed  CAS  Google Scholar 

  4. Hove LM. Epidemiology of scaphoid fractures in Bergen, Norway. Scand J Plast Reconstr Surg Hand Surg. 1999;33:423–6.

    Article  PubMed  CAS  Google Scholar 

  5. Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg Am. 1980;5:508–13.

    PubMed  CAS  Google Scholar 

  6. Mack GR, Bosse MJ, Gelberman RH, Yu E. The natural history of scaphoid non-union. J Bone Joint Surg Am. 1984;66:504–9.

    PubMed  CAS  Google Scholar 

  7. Lindstrom G, Nystrom A. Natural history of scaphoid non-union, with special reference to "asymptomatic" cases. J Hand Surg Br. 1992;17:697–700.

    Article  PubMed  CAS  Google Scholar 

  8. Sjolin SU, Andersen JC. Clinical fracture of the carpal scaphoid–supportive bandage or plaster cast immobilization? J Hand Surg Br. 1988;13:75–6.

    PubMed  CAS  Google Scholar 

  9. Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney WP 3rd, Linscheid RL. Scaphoid malunion. J Hand Surg Am. 1989;14:679–87.

    Article  PubMed  CAS  Google Scholar 

  10. Kumar S, O'Connor A, Despois M, Galloway H. Use of early magnetic resonance imaging in the diagnosis of occult scaphoid fractures. the CAST Study (Canberra Area Scaphoid Trial). N Z Med J. 2005;118:U1296.

    PubMed  Google Scholar 

  11. Bond CD, Shin AY, McBride MT, Dao KD. Percutaneous screw fixation or cast immobilization for nondisplaced scaphoid fractures. J Bone Joint Surg. 2001;83–A:483–8.

    PubMed  Google Scholar 

  12. Ram AN, Chung KC. Evidence-based management of acute nondisplaced scaphoid waist fractures. J Hand Surg Am. 2009;34:735–8.

    Article  PubMed  Google Scholar 

  13. • Ibrahim T, Qureshi A, Sutton AJ, Dias JJ. Surgical vs nonsurgical treatment of acute minimally displaced and undisplaced scaphoid waist fractures: pairwise and network meta-analyses of randomized controlled trials. J Bone Joint Surg Am. 2011;36:1759–68. A meta-analysis of randomized control trials comparing surgical vs nonsurgical management of acute minimally and non-displaced scaphoid waist fractures. Six studies (363 patients) were eligible for pairwise analysis. The odds ratio of fracture union favored surgical management but did not reach statistical significance and surgical management was associated with a significantly elevated risk of complication. The authors concluded that current literature does not support routine surgical treatment of minimally and non-displaced acute scaphoid waist fractures.

    Google Scholar 

  14. Rettig AC, Kollias SC. Internal fixation of acute stable scaphoid fractures in the athlete. Am J Sports Med. 1996;24:182–6.

    Article  PubMed  CAS  Google Scholar 

  15. Kuo K, Wolfe SW. Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am. 2008;33:998–1013.

    Article  PubMed  Google Scholar 

  16. Hwang JJ, Goldfarb CA, Gelberman RH, Boyer MI. The effect of dorsal carpal ganglion excision on the scaphoid shift test. J Hand Surg Br. 1999;24:106–8.

    Article  PubMed  CAS  Google Scholar 

  17. Rosner JL, Zlatkin MB, Clifford P, Ouellette EA, Awh MH. Imaging of athletic wrist and hand injuries. Semin Musculoskelet Radiol. 2004;8:57–79.

    Article  PubMed  Google Scholar 

  18. Darlis NA, Kaufmann RA, Giannoulis F, Sotereanos DG. Arthroscopic debridement and closed pinning for chronic dynamic scapholunate instability. J Hand Surg Am. 2006;31:418–24.

    Article  PubMed  Google Scholar 

  19. Manuel J, Moran SL. The diagnosis and treatment of scapholunate instability. Hand Clin. 2010;26:129–44.

    Article  PubMed  CAS  Google Scholar 

  20. Dohi Y, Omokawa S, Ono H, Aoki M, Akahane M, Wada T, et al. Arthroscopic gap distance can predict the degree of scapholunate ligament tears: a cadaver study. J Orthop Sci. 2012;17:64–9.

    Article  PubMed  Google Scholar 

  21. Szabo RM. Scapholunate ligament repair with capsulodesis reinforcement. J Hand Surg Am. 2008;33:1645–54.

    Article  PubMed  Google Scholar 

  22. Blazar PE, Chan PS, Kneeland JB, Leatherwood D, Bozentka DJ, Kowalchick R. The effect of observer experience on magnetic resonance imaging interpretation and localization of triangular fibrocartilage complex lesions. J Hand Surg Am. 2001;26:742–8.

    Article  PubMed  CAS  Google Scholar 

  23. • Iordache SD, Rowan R, Garvin GJ, Osman S, Grewal R, Faber KJ. Prevalence of triangular fibrocartilage complex abnormalities on MRI scans of asymptomatic wrists. J Hand Surg Am. 2012;37:98–103. A prospective diagnostic study evaluating wrist MRIs of 103 asymptomatic volunteers. All studies were reviewed by 2 musculoskeletal radiologists and 1 orthopaedic surgeon with specific comment on TFCC morphology and pathology. The TFCC was considered abnormal in 39 asymptomatic wrists. Increased age was correlated with TFCC abnormality. Results indicate that the prevelence of incidental TFCC findings is high, particularly in patients over the age of 50.

    Article  PubMed  Google Scholar 

  24. Palmer AK. Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am. 1989;14:594–606.

    Article  PubMed  CAS  Google Scholar 

  25. Nagle DJ. Triangular fibrocartilage complex tears in the athlete. Clin Sports Med. 2001;20:155–66.

    Article  PubMed  CAS  Google Scholar 

  26. Chloros GD, Wiesler ER, Poehling GG. Current concepts in wrist arthroscopy. Arthroscopy. 2008;24:343–54.

    Article  PubMed  Google Scholar 

  27. Yao J, Dantuluri P, Osterman AL. A novel technique of all-inside arthroscopic triangular fibrocartilage complex repair. Arthroscopy. 2007;23:1357.

    PubMed  Google Scholar 

  28. Yao J, Lee AT. All-arthroscopic repair of Palmer 1B triangular fibrocartilage complex tears using the FasT-Fix device. J Hand Surg Am. 2011;36:836–42.

    Article  PubMed  CAS  Google Scholar 

  29. Vigler M, Aviles A, Lee SK. Carpal fractures excluding the scaphoid. Hand Clin. 2006;22:501–16.

    Article  PubMed  Google Scholar 

  30. Whalen JL, Bishop AT, Linscheid RL. Nonoperative treatment of acute hamate hook fractures. J Hand Surg Am. 1992;17:507–11.

    Article  PubMed  CAS  Google Scholar 

  31. Saint-Cyr M, Oni G, Wong C, Sen MK, LaJoie AS, Gupta A. Dorsal percutaneous cannulated screw fixation for delayed union and nonunion of the scaphoid. Plast Reconstr Surg. 2011;128:467–73.

    Article  PubMed  CAS  Google Scholar 

  32. • Scheufler O, Radmer S, Andresen R. Dorsal percutaneous cannulated mini-screw fixation for fractures of the hamate hook. Hand Surg. 2012;17:287–93. The authors present a case series of 21 patients with dynamic ultrasound‐confirmed, symptomatic ECU subluxation and describe their preferred technique for reconstruction. The technique involves deepening of the ECU groove in the distal ulna and suture anchor repair of the tendon sheath. They report improvement in clinical outcomes including range of motion, pain, satisfaction and DASH scores at an average 31 months post‐operatively.

    Article  PubMed  Google Scholar 

  33. MacLennan AJ, Nemechek NM, Waitayawinyu T, Trumble TE. Diagnosis and anatomic reconstruction of extensor carpi ulnaris subluxation. J Hand Surg Am. 2008;33:59–64.

    Article  PubMed  Google Scholar 

  34. Inoue G, Tamura Y. Recurrent dislocation of the extensor carpi ulnaris tendon. Br J Sports Med. 1998;32:172–4.

    Article  PubMed  CAS  Google Scholar 

Download references

Disclosure

DT Fufa: none; CA Goldfarb: Receives royalties from Wolters Kluwer.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Duretti T. Fufa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fufa, D.T., Goldfarb, C.A. Sports injuries of the wrist. Curr Rev Musculoskelet Med 6, 35–40 (2013). https://doi.org/10.1007/s12178-012-9145-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12178-012-9145-8

Keywords

Navigation