The wrist: common injuries and management

Primary care physicians not only have an important role in the diagnosis and initial treatment of wrist injuries, but also play a key role in the education of families about prevention. Children and adolescents are often competitive in sports throughout the year. Periods of rest can be important in prevention of overuse injuries in the very active, developing athlete. Protective gear such as wrist guards, used during activities such as inline skating and snowboarding, has been shown to prevent acute injuries that often require surgery or lead to prolonged disability [84,85].A primary care physician will often be the first health care provider to assess most wrist complaints. The intent of this article is to familiarize the primary care physician with the most common wrist injuries in active people, and to demonstrate that many injuries can have poor outcomes if unrecognized. It is important to have good clinical knowledge of the functional anatomy of the wrist in order to maximize the information gathered on examination and to narrow one's differential diagnosis. The athlete's sport and desires regarding return to play, and the impact of the timing of injury management on his or her further participation in sport are important to consider. A highly active person may be referred to a musculoskeletal specialist for advanced testing or surgical repair earlier in the evaluation of certain injuries than a less active one. Armed with good clinical knowledge of anatomy and an understanding of common wrist injuries,primary care physicians can successfully manage many wrist complaints.