[Sprains and dislocations of the wrist joint and carpal bones]

In case of persistent swelling and painful limitation of mobility, "distorsion" can be accepted as the definitive diagnosis, only if osseous and ligamentous injuries of the wrist and carpus have been ruled out with sufficient certainty. According to current knowledge multiform injuries of the carpus originate from a three dimensional impact of forces, which besides the well-known hyperextension and ulnar deviation of the wrist include intercarpal supination as a rotatory component. Depending on the effective forces and due to the biomechanical strength of the restraining ligaments (which changes in relation to carpal declination), a progressive perilunar instability develops around the lunate bone, extending from the radial to the ulnar side of the radiocarpal joint.