Definition of wrist sprains:
In sports surgery, severe wrist sprains, lesions to the scapholunate or TFCC ligament, are indeed less frequent than wrist fractures. But these sports injuries can have significant medical consequences on the way the wrist ages, especially in the athlete. Among severe wrist sprains, lesions to the TFCC ligament are found especially in sports accidents where the wrist is bent forcefully.
The TFCC ligament is a fibrocartilaginous complex located on the radial part of the wrist joint, it is not vascularised on its radial side. For this reason, in sports injuries where the TFCC ligament is severely sprained, only ulnar lesions can be repaired durably, in particular by wrist arthroscopy for athletes.
Video of arthroscopic surgery for wrist sprain:
The main complaint reports pain in resistive prono-supination movements.
This frontal section CT arthrography of the wrist shows an ulnar tear of the TFCC ligament, with a leak of the contrast agent into the distal radioulnar joint.
Surgical treatment for wrist sprains
Arthroscopic repair is performed on an outpatient basis under locoregional anaesthesia.
Only three 2-mm incisions are necessary.
The assessment of the lesions is conducted through the radiocarpal arthroscopic portal; in this case we can see an old lesion with loss of trampoline effect and inflamed synovitis opposite. The lesion is then debrided with a shaver.
To reattach the ligament, an ulnar path is then used: two needles are introduced on either side of the cubital styloid through the TFCC ligament.
Two threads are passed through the needles and secondarily retrieved so as to form a U stitch that will be put under tension so as to reattach the ligamentous disc to the inner capsule surface. The threads are then tied on the ulnar side of the wrist, with the stitch secured by the styloid .
Repair solidity and trampoline effect restoration are verified.
The incisions are closed with Steri-strip.
Recovery after wrist sprain surgery
Wrist immobilization with a removeable splint will be necessary for 5 weeks.
This is the cosmetic result at 1 month.
Rugby will resume after 2 to 3 months.