From the Research
The management of a wrist joint dislocation involves prompt reduction followed by immobilization and rehabilitation, with the goal of minimizing morbidity, mortality, and improving quality of life. Initial treatment requires closed reduction under appropriate analgesia or sedation, ideally performed by an orthopedic specialist 1. After successful reduction, the wrist should be immobilized in a short arm cast or splint for 4-6 weeks, with the position determined by the specific dislocation pattern.
- Key considerations in management include:
- Prompt and accurate radiographic diagnosis to guide treatment planning 1
- The use of CT scans to better show the extent of the injury, particularly in cases of delayed treatment or chronic perilunate dislocation 1
- Pain management with NSAIDs such as ibuprofen or naproxen, and acetaminophen as needed
- A structured rehabilitation program starting with gentle range of motion exercises and progressing to strengthening exercises
- Surgical intervention may be necessary for irreducible dislocations, associated fractures, or ligamentous injuries causing instability, with the choice of surgical method depending on the specific injury and patient factors 2.
- Complications of wrist dislocations include chronic instability, post-traumatic arthritis, and median nerve injury, making proper initial management crucial to prevent long-term morbidity and improve quality of life 3.
- Early reduction is particularly important to minimize soft tissue damage and prevent avascular necrosis of carpal bones, especially the scaphoid and lunate which have tenuous blood supplies.
- A high index of suspicion and careful evaluation of radiographs are essential in diagnosing these injuries, as they may be missed in an acute setting 3.