Wrist Dislocation, Radius or Ulna

An injury to one of the joints in the wrist so that adjoining bones no longer touch each other. Subluxation is a minor dislocation. Joint surfaces still touch but not in normal relation to each other.

Body Parts Involved

• Lower arm bones (radius and ulna).
• Bones in the hand.
• Ligaments that hold the bones in place.
• Soft tissue surrounding the dislocation site, including periosteum (covering to bone), nerves, tendons, blood vessels and connective tissue.

Causes

• Direct blow to the wrist-usually a fall on an extended hand.
• End result of a severe wrist sprain.
• Congenital abnormality, such as shallow or malformed joint surfaces.

Signs & Symptoms

• Excruciating pain in the wrist at the time of dislocation.
• Loss of hand and wrist function, as well as severe pain when attempting to move them.
• Visible deformity if the dislocated bones have locked in the dislocated position. Bones may spontaneously reposition themselves and leave no deformity, but damage is the same.
• Tenderness over the dislocation.
• Swelling and bruising at the injury site.
• Numbness or paralysis below the dislocation from pressure, pinching or cutting of blood vessels or nerves.

Treatment

Note:- Follow your doctor's instructions. These instructions are supplemental.

First Aid

• Keep the person warm with blankets to decrease the possibility of shock.
• Cut away clothing if possible, but don't move the injured area to remove clothing.
• Immobilize the wrist joint and arm with padded splints.
• Follow instructions for R.I.C.E., the first letters, ice, compression and elevation.

Continuing Care

If a cast not necessary:

• Use ice soaks 3 or 4 times a day. Fill a bucket with ice water, and soak the injured area 20 minutes at a time.
• After 48 hours, apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
• Take whirlpool treatments, if available.
• Massage gently and often to provide comfort and decrease swelling. Stroke from the fingers the heart.
• Wrap the injured wrist with an elasticized bandage between treatments

If a cast or plaster splint is necessary:

• Actively exercise all muscle groups in the arm and hand that are not immobilized. Muscle contractions promote proper alignment and hasten healing.

Medication

Your doctor may prescribe:

• General anesthesia or muscle relaxants to make joint manipulation possible.
• Acetaminophen to relieve moderate pain.
• Narcotic pain relievers for severe pain.
• Antibiotics to fight infection if surgery is necessary.

Home Diet

• Drink only water before manipulation or surgery to correct the dislocation. Solid food in your stomach makes vomiting while under general anesthesia more hazardous.
• During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Diagnostic Measures

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• X-rays of the wrist, hand and elbow.

Prevention Tips

• Build your overall strength and muscle tone with a long-term conditioning program appropriate for your sport.
• Warm up adequately before physical activity.
• After healing, use protective devices such as wrapped elastic bandages or tape wraps, to prevent reinjury during participation in Sports.
• Consider avoiding contact sports if treatment does not restore a strong, stable wrist.