Wrist injuries and Syndromes

Dr Jeffrey Budoff Top Houston Wrist Surgeon

DeQuervain’s Tendinitis

leads to inflammation of the tendons that control thumb movement, resulting in pain, swelling, and difficulty gripping or twisting objects. Common in new parents, manual laborers, and those with repetitive strain, symptoms typically worsen with thumb or wrist motion. Treatment may include rest, splinting, anti-inflammatory medications, corticosteroid injections, or, in severe cases, surgical release to relieve pressure and restore normal tendon function.

Intersection Syndrome

occurs where the tendons that extend the thumb and wrist intersect and rub against each other, leading to inflammation and irritation. Common in athletes and individuals performing repetitive wrist movements—such as rowing, weightlifting, or manual labor—it often presents with aching, tenderness, and a squeaking or creaking sensation during motion. Treatment typically includes rest, splinting, anti-inflammatory medications, and physical therapy, with surgery rarely needed in persistent cases.

Flexor Carpi Radialis (FCR) Tendinitis

This condition often affects individuals who perform repetitive wrist motions, such as typing, lifting, or racquet sports. Symptoms include localized pain, tenderness over the tendon near the wrist, and discomfort with wrist flexion or resistance. Treatment typically involves rest, activity modification, splinting, anti-inflammatory medications, and physical therapy to reduce irritation and restore normal wrist function.

Flexor Carpi Ulnaris (FCU) Tendinosis

Unlike tendinitis, which involves inflammation, tendinosis is characterized by chronic wear and microtears in the tendon tissue. Common in athletes and individuals with repetitive wrist strain, symptoms include aching pain near the wrist or elbow, tenderness along the tendon, and weakness with wrist motion. Treatment focuses on rest, activity modification, physical therapy, and sometimes bracing to promote tendon healing and restore function.

Extensor Carpi Ulnaris (ECU) Tendon

Runs along the outer forearm and can become irritated or injured due to overuse, repetitive motions, or trauma—especially in athletes who perform forceful wrist actions, like tennis players or golfers. ECU tendon problems can cause pain, swelling, clicking sensations, or instability on the outer side of the wrist. Treatment typically involves rest, bracing, anti-inflammatory medications, and physical therapy, with surgical intervention considered in more severe or chronic cases.

Ganglion Cysts

These cysts can vary in size and may fluctuate over time, often becoming more prominent with activity. While usually painless, they can cause discomfort, limit joint movement, or press on nearby nerves, leading to tingling or weakness. Ganglion cysts are typically diagnosed through physical exam and imaging. Treatment options range from observation and aspiration to surgical removal if the cyst is painful, recurrent, or interferes with hand function.

Distal Radius Fractures

These fractures often result from falls onto an outstretched hand or direct trauma and can range from simple, non-displaced breaks to complex, displaced or comminuted fractures. Symptoms include wrist pain, swelling, bruising, and limited motion or deformity. Treatment depends on the severity and may involve casting, splinting, or surgical fixation with plates and screws. Prompt care is essential to ensure proper healing, restore wrist function, and prevent long-term stiffness or arthritis.

Distal Radius Malunions

Can result in pain, decreased range of motion, reduced grip strength, and visible deformity. Malunions may affect wrist mechanics and increase the risk of arthritis or tendon irritation over time. Treatment depends on the severity and symptoms, ranging from therapy and bracing in mild cases to corrective osteotomy surgery in more significant deformities to realign the bone and restore function.

Scaphoid Fractures

These fractures often result from a fall onto an outstretched hand and may cause pain, swelling, and tenderness in the area just below the base of the thumb. Because the scaphoid has a limited blood supply, healing can be slow and complications such as nonunion or avascular necrosis may occur if not properly treated. Depending on the severity, treatment may include casting, splinting, or surgical fixation to ensure proper healing and restore wrist function.

Hook of Hamate (Hamulus) Fractures

These fractures are often seen in athletes who use bats, rackets, or clubs, where repetitive impact or acute trauma can cause a break. Symptoms include deep wrist or palm pain, especially when gripping, along with tenderness over the hypothenar (pinky-side) region. If left untreated, it can lead to chronic pain or nerve irritation. Treatment may involve immobilization or surgical excision of the bone fragment for persistent symptoms.

Forearm Fractures

These fractures commonly result from falls, direct blows, or high-impact trauma such as sports injuries or car accidents. Symptoms typically include pain, swelling, bruising, and difficulty rotating or using the arm. In more severe cases, visible deformity or bone displacement may occur. Treatment depends on the type and severity of the fracture and may include casting, splinting, or surgical fixation with plates and screws to realign the bones and restore proper function. Prompt care is essential for optimal healing and recovery.

Scapho-Lunate (SL) Ligament Injuries

These are often caused by falls onto an outstretched hand or high-impact trauma, these injuries can lead to wrist pain, swelling, clicking, and weakness, particularly during gripping or weight-bearing activities. If left untreated, SL ligament tears can result in joint instability and lead to long-term complications like arthritis. Treatment ranges from splinting and therapy for mild injuries to surgical repair or reconstruction in more severe cases to restore wrist stability and function.

Luno-Triquetral (LT) Ligament Injuries

These injuries often occur due to falls, twisting motions, or direct trauma, leading to wrist pain, swelling, and tenderness over the ulnar side, especially during motion or gripping. In some cases, patients may also experience clicking or instability in the wrist. Diagnosis often requires advanced imaging such as MRI or wrist arthroscopy. Treatment can include splinting, hand therapy, or surgical repair, depending on the severity of the ligament damage and the degree of wrist instability.

Triangular Fibrocartilage Complex (TFC or TFCC) Tear

TFCC tears can result from falls, overuse, or degenerative wear, and symptoms often include pain on the ulnar side of the wrist, clicking, weakness, and limited range of motion. Treatment may range from rest, splinting, and physical therapy to surgical repair or debridement in more severe or persistent cases to restore wrist stability and function.

Wrist Arthritis

Wrist arthritis is a degenerative condition that occurs when the cartilage in the wrist joints wears down over time, leading to pain, stiffness, swelling, and reduced range of motion. It can result from aging (osteoarthritis), previous injuries, or inflammatory conditions like rheumatoid arthritis. Symptoms often worsen with activity and may interfere with daily tasks that require wrist movement or grip strength. Treatment options include lifestyle modifications, splinting, anti-inflammatory medications, corticosteroid injections, and, in advanced cases, surgical procedures to relieve pain and restore wrist function.

Kienbock's Disease

Kienböck’s disease is a rare condition that occurs when the blood supply to the lunate bone in the wrist is disrupted, leading to bone death (avascular necrosis). Over time, this can cause the bone to collapse, resulting in chronic wrist pain, stiffness, swelling, and reduced grip strength. The exact cause is often unclear, but trauma or repetitive stress may contribute. Early diagnosis is crucial to slow progression and preserve wrist function. Treatment options range from immobilization and activity modification to surgical procedures that restore blood flow or redistribute pressure within the wrist.

Wrist Pain

Wrist pain can be caused by many disorders: tendon entrapment, tendon degeneration, occult ganglion cysts (that are too small to be seen, but still press on nerves or other sensitive structures), fractures, ligament injuries, Triangular Fibrocartilage injuries, Kienbock’s Disease and arthritis.