A New Definition of Wrist Sprain Necessary after Findings in a Prospective MRI study by Bergh TH, Lindau T, Bernardshaw SV, et al, Injury, International Journal of Care for the Injured, 2012; 43:1732-142

A prospective study of emergency department patients included patients who sustained an acute wrist injury. While these were patients age 18 to 49, this article has important implications for patients under 18. They divided the mechanism of injury into high and low injury trauma. The patients had routine plain film x-rays. Patients received an MRI within 0-31 days after the trauma. 155 patients were included. 30 of the MRI’s were normal.

There were 54 fractures identified, 56 bone bruises, and multiple ligamentous injuries including five injuries to the scapholunate ligament.

The conclusions were that wrist sprains should be defined as an occult partial or complete soft tissue, or bony injury, with negative plain films. The MRI obtained particularly for patients who did not improve with initial treatment and identified multiple important occult injuries that required a change in treatment.