A Fall On an OutStretched Hand (FOOSH) can cause significant injury to the wrist. These injuries can cause radial-sided (the side nearer the thumb) and/or ulnar-sided (the side nearer the little finger) wrist pain.
Causes of persistent radial-sided wrist pain after a FOOSH include:
- Scaphoid fracture or scaphoid non-union
- Fracture of the distal radius
- Scapholunate intercarpal ligament (SLIL) injury
- Thumb carpometacarpal joint injury including fractures or ligament injuries
- Tendinosis of the flexor carpi radialis (FCR) tendon
- Uncommonly, perilunate injury
Causes of persistent ulnar-sided wrist pain after a FOOSH include:
- Ulnar styloid, ulnar head or neck fractures
- Injury to the triangular fibrocartilaginous complex (TFCC)
- Lunotriquetral (LT) ligament injury
- Tendinosis of the extensor carpi ulnaris (ECU) or flexor carpi ulnaris (FCU) tendons
- Uncommonly, complex ligament injuries resulting in midcarpal instability
A hand & wrist specialist will evaluate your wrist through detailed history taking to determine the mechanism of injury. Meanwhile, clinical examination is used to determine the location of the injury and order investigations such as:
- X-rays with special views,
- CT scans or
- MRI scans.
The relevant treatment and management plan will then be compiled, tailoring to the patient's individual needs (a professional athlete will have a higher demand in function as compared to a sedentary retiree). The hand occupational therapist working with the hand & wrist surgeon will also be briefed on the post-treatment therapy protocol to meet these individual demands.
Fortunately, with early diagnosis and treatment, one can regain full function and strength in the hand and wrist without pain. One should consider seeking a consultation with a hand & wrist specialist to achieve this restoration and elimination of pain and prevent future complications such as secondary osteoarthritis and permanent joint deformity.
