Wrist injuries in sport.

Abstract

The wrist is a complex joint that biomechanically transmits forces generated at the hand through to the forearm. The radial side of the wrist carries 80% of the axial load and the ulnar side the remaining 20% of the load. The incidence of wrist (and hand) injuries in the sporting population is approximately 25%. This tends to be higher in those sports using the hand and wrist, and when the potential for trauma is present. The injuries are divided into 4 categories: overuse, nerve (and vascular), traumatic, and weight-bearing injuries. Overuse injuries are common in sports involving the hand and wrist, such as racquet sports, netball, basketball and volleyball. Nerve injuries are more commonly compressive neuropathies, and are seen with cyclists who may compress the ulnar nerve in Guyon's canal. Vascular injuries are uncommon and usually result from a high velocity impact from balls. Traumatic injuries are the most common and are due to either a fall on to the wrist, a direct blow, or combination of a rotatory and torsional force. The weight-bearing injuries are more specific to gymnastics, and result from repetitive excessive compressive and rotational forces across the wrist. The pommel horse event is associated with a high incidence of wrist pain in male competitors. Arthroscopy of the wrist provides direct inspection of intra-articular structures and diagnosis of conditions that may be unclear with other investigations. As techniques advance, more conditions may be treated arthroscopically and potentially facilitate an earlier return to sport.