There are a number of short, tight ligaments that work to stabilize the eight bones of the wrist, and these stabilizers are referred to as the wrist ligaments. These ligaments not only connect the wrist bones to each other, but also connect the wrist with the radius and ulna bones in the arm and the metacarpal bones in the fingers. The wrist ligaments are categorized in several ways. First they may be considered to be intrinsic or extrinsic wrist ligaments. They can also be classified as volar — on the palm side — or dorsal — on the back of the hand and wrist. Problems with the wrist ligaments can arise from several types of injury.
Wrist ligaments can develop problems from repetitive motion or from injuries during a single motion of throwing, impact, twisting, or weight-bearing. One of the most well-known problems of the wrist is carpal tunnel syndrome, in which the median nerve is compressed, causing pain, numbness, or weakness when the hand is used. Though usually due to other causes, it is possible for the transverse carpal ligament to be implicated in carpal tunnel syndrome if it has thickened and narrowed the opening for the nerve.
Because everything in the wrist is so compact and tightly connected, any bones shifting out of place can cause damage to the wrist ligaments. This is the case if there is a subluxation of the wrist, in which a bone of the wrist joint is partially dislocated, or if there is a full dislocation. Even when everything is back in place, the ligaments may still need time to heal.
What is commonly called a “wrist sprain” actually refers to stretching or tearing—partial or complete—of one or more wrist ligaments. Sprains may be diagnosed using a physical examination, and if that is deemed insufficient, arthroscopy, a bone scan, CT scan, MRI scan, or X-ray. Sprains are classified by grade. Grade 1 is a situation in which there is stretching and/or microtears. Grade 2 refers to a partial tear of a ligament. Grade 3 is a severe or complete ligament tear.
Preventing problems with the wrist ligaments is only rarely a possibility. It may be possible if one has risk factors, such as poor balance and coordination, limited flexibility, and loose joints, to address them through a program of physical therapy. Taking proper precautions when participating in sports, including wearing wrist guards for activities like in-line skating, can also help prevent injuries. Most wrist injuries are not preventable.
