First aid - Wrist Injury:

Overview:
The wrist is made up of the two bones of the forearm (the radius and ulna) and
eight carpal bones (scaphoid or navicular, lunate, triquetrum, pisiform,
trapezium, trapezoid, capitate, and the hamate). Many ligaments connect these

bones to each other.

A sprain is an injury to the wrist ligaments without any evidence of bone injury
(that is, no broken bones or cracks in the bone). With a sprain, there is usually
only a partial tearing of the ligaments. In a severe wris t sprain, there can be a
complete tear.
A fractured or broken wrist means there is a break or a crack in one or more of
the bones of the wrist.
A strain is where there is a tearing of the muscle fibers in the area surrounding
the wrist.
Definition:
A sprain is an injury to a ligament. Ligaments are strong bands of connective
tissue that connect one bone to another.
A wrist sprain is a common injury. There are many ligaments in the wrist that
can be stretched or torn, resulting in a sprain. This occurs when the wrist is
bent forcefully, such as in a fall onto an outstretched hand.
Alternative Names:
Transverse wrist fracture; Dinner-fork deformity of the wrist.

Types of wrist injury:

Wrist sprains can range from mild to severe. They are graded, dependin g on the
degree of injury to the ligaments.

Grade 1: These mild sprains occur when the ligaments are stretched, but
not torn.

Grade 2: These moderate sprains occur when the ligaments are partially
torn. Grade 2 sprains may involve some loss of function.

Grade 3: These severe sprains occur when the ligament is completely

torn. These are significant injuries that require medical or surgical care.
As the ligament tears away from the bone, it may also take a small chip of
bone with it, called an avulsion fracture.

Causes:
This injury usually occurs when a person attempts to break a fall by throwing
the hands and arms out in front of them. The hands meet the ground with the
body weight behind them. The radius and ulna (the bones in the forearm) may
buckle or break just above the wrist.
This injury is more likely to happen during sports such as rollerblading,
skateboarding, running, or any other activity in which a forward fall can occur
while a person is moving at a higher speed.
Bones become more brittle (from osteoporosis) in adults ages 50 - 60 and older.
Older adults are more likely to fracture a bone, even while walking slowly.
The most common cause of wrist injuries is a fall on an outstretched hand:

You can also have wrist pain from repetitive use that results in an
inflammation of the tendons (tendonitis). This is termed a repetitive
motion injury and is really not a true sprain.

Carpal tunnel syndrome is another common wrist injury that may occur
from repetitive motion.

High force or weight through the wris.

Symptoms:
Symptoms of a wrist sprain may vary in intensity and location. The most
common symptoms of a wrist sprain include:

Swelling in the wrist.

Pain at the time of the injury.

Persistent pain when you move your wrist.

Bruising or discoloration of the skin around the wrist.

Tenderness at the injury site.

A feeling of popping or tearing inside the wrist.

A warm or feverish feeling to the skin around the wrist.

Sometimes, a wrist injury may seem mild with very little swelling, but it could be
that an important ligament has been torn that will require surgery to avoid
problems later.
Similarly, an unrecognized (occult) fracture may be mistakenly considered a
mild or moderately sprained wrist. If left untreated, the broken bone may not
heal and will require a surgery that could have been avoided with early,
appropriate treatment. The most common example of this is an occult fracture of
the scaphoid bone.
It is important in all but very mild cases for a doctor to evaluate a wrist injury.
Proper diagnosis and treatment of wrist injuries is necessary to avoid long -
lasting stiffness and pain.

First Aid:
 Reassure the injured person.

Place the hand and wrist in a splint in a normal resting position.

o Place a rigid splint on the underside of the wrist, hand, and
forearm.
o Place a padded object such as a sock, wadded cloth, or rolled
elastic bandage in the palm.
o Wrap the wrist, hand, splint, and padded object. Do not wrap too
tightly, and keep the fingertips uncovered.

Elevate the wrist or place it in a sling.

Use an ice pack over the wrist to help reduce swelling.

Bring the person to an urgent care center or emergency medical facility.

Do NOT attempt to move or straighten the wrist or hand.

RICE Method:
Mild wrist sprains can usually be treated at home with the RICE protocol.

R Rest the joint for at least 48 hours.

I Ice the injury to reduce swelling.

Do not apply ice directly to the skin. Use an ice pack or wrap a towel
around the ice or a package of frozen vegetables. Apply ice for about 20
minutes at a time.

C Compress the swelling with an elastic bandage.

E Elevate the injury above the level of the heart.

A pain reliever, such as aspirin or ibuprofen, may be helpful. If pain and

swelling persist for more than 48 hours, however, see a doctor.

When to Seek Medical Care:

If you have severe pain, deformity, numbness, or are unable to move your wrist,
you should call your doctor for an immediate appointment, go to an urgent care
clinic, or go to a hospital's emergency department.
If there is no deformity and the pain is manageable with over -the-counter pain
medication, you may want to wait 12-24 hours before deciding whether to call
the doctor. If symptoms persist after a day, see a doctor.
If you have obvious deformity, numbness, or severe pain, you need medical
attention.

If there is obvious deformity or severe swelling, there may be a broken

bone that needs to be moved back into its normal position.

There also can be a dislocation where the bones are no longer in the
correct position, although they are not broken.

Considerations:
W rist fractures are common among children and the elderly.

Children's bones are soft and tend to get buckle (torus) fractures. These
are incomplete fractures on one side of the bone.

Because bones become brittle with age, a complete fracture is more likely
in adults and among the elderly. This is called a Colles' fracture.

Fractures that are not severe may be placed in a splint and sling, or a
lightweight, fiberglass cast.
If the bone is no longer straight because of the fracture, it must be reduced
(straightened).

The health care provider may be able to use local anesthesia and reduce
the fracture.

In other cases, surgery may be needed. The break may need to be fixed
with a plate and screws, pins, or other metal or plastic hardware.

Older people with Colles' fractures often fail to regain full mobility of the wrist
joint. Carpal tunnel syndrome may occur as an early or late complication of the
injury. Chronic pain may result from injury to the ligam ents or the joint surface
of the wrist.
Prevention:
The following tips may prevent finger, hand, and wrist injuries.

Do exercises that strengthen your hand and arm muscles.

Learn safe hand and wrist movements to avoid an injury.

 Reduce the speed and force of repetitive movements in activities such as
hammering, typing, knitting, quilting, sweeping, raking, playing racquet
sports, or rowing.

Change positions when you hold objects, such as a book or playing cards,

for any length of time.

Use your whole hand to grasp an object. Gripping with only your thumb
and index finger can stress your wrist.

Consider wearing gloves that support the wrist and have vibration -
absorbing padding when working with tools that vibrate.

Use safety measures, such as gloves, and follow instructions for the
proper use of hand and power tools.

Use caution when using knives in preparing food or craft activities.

Supervise a child using knives or sharp scissors in craft activities.

Wear protective gear, such as wrist guards, in sports ac tivities. Be sure to

learn what you can do to help prevent injuries for your child too.

Review your work posture and body mechanics.

o Organize your work so that you can change your position
occasionally while maintaining a comfortable posture.
o Position your work so you do not have to turn excessively to either
side.
o Keep your shoulders relaxed when your arms are hanging by your
sides.
o When using a keyboard, keep your forearms parallel to the floor or
slightly lowered, and keep your fingers lower than your wrists. Allow
your arms and hands to move freely. Take frequent breaks to
stretch your fingers, hands, wrist, shoulders, and neck. If you use a
 wrist pad during breaks from typing, it's best to rest your palm or
the heel of your hand on the support, rather than your wrist.

Home treatment for a minor hand or wrist injury:

Home treatment may help relieve pain, swelling, and stiffness.

Remove all rings, bracelets, or any other jewellery that goes around a
finger or wrist. It will be harder to remove the jewellery later if swelling
increases.

Use rest, ice, compression, and elevation (RICE) for pain and swelling.

Do not use your injured hand or wrist for the first 24 hours after an injury,
if possible. An elastic bandage can help decrease swelling. The wrap will
also remind you to rest the injured hand or wrist. A wrist splint can help
support an injured wrist. Talk to your doctor if you th ink you need to use a
splint or bandage for more than 48 to 72 hours.

Gently massage or rub the area to relieve pain and encourage blood flow.
Do not massage the injured area if it causes pain.

For the first 48 hours after an injury, avoid things that might increase
swelling, such as hot showers, hot tubs, hot packs, or alcoholic
beverages.

After 48 to 72 hours, if swelling is gone, apply heat and begin gentle

exercise with the aid of moist heat to help restore and maintain flexibility.
Some experts recommend alternating between heat and cold treatments.

Treat blisters.
Keep your bones strong:
Eat a nutritious diet with enough calcium and vitamin D , which helps your
body absorb calcium. Calcium is found in dairy products, such as milk,
cheese, and yogurt; dark green, leafy vegetables, such as broccoli; and
other foods.

Exercise and stay active. It is best to do weight -bearing exercise, such as

walking, jogging, stair climbing, dancing, or lifting weights, for 2 hours a
week. One way to do this is to be active 30 minutes a day, at least 5 days
a week. In addition to weight-bearing exercise, experts recommend that
you do resistance exercises at least 2 days a week. Talk to your doctor
about an exercise program that is right for you. Begin slowly, espe cially if
you have not been active. For more information, see the topic Fitness.

Limit how much alcohol you drink.

Don't smoke or use other tobacco products. Smoking puts you at a much
higher risk of developing osteoporosis. It also interferes with blood supply
and healing. For more information, see the topic Quitting Smoking.