Wrist ligament injuries
Wrist ligament injuries - your guide to repair, reconstruction, and rehab
Wrist pain that lingers after a “sprain” could be a torn ligament. Our Perth hand and wrist surgeons will assess the problem, explain your choices simply, and build a treatment plan around your goals.
Wrist ligament injuries Perth
Understanding wrist ligament injuries
"Many so-called wrist sprains are actually ligament tears. The difference matters. A missed tear can quietly de-stabilise the wrist and cause long-term issues like arthritis."
Wrist ligaments help the small bones in your wrist move together smoothly and remain stable. When one tears, everything changes. Some people feel a sharp pain right away. Others don’t realise anything’s wrong until they notice aching, weakness, or clicking that won’t go away. A torn ligament can lead to long-term instability and arthritis if it’s not diagnosed and treated properly.
The most common injury is a scapholunate ligament tear. This ligament connects two important wrist bones, the scaphoid and lunate. When it fails, the scaphoid may tilt, the space between the bones increases, and the wrist loses its normal rhythm. People often feel pain when gripping, doing push-ups, lifting a kettle, or weight-bearing on the palm. Getting it looked at early is key. Early diagnosis may increase the likelihood of successful arthroscopic repair, while delayed treatment can reduce the surgical options available.
Signs your wrist ligament needs attention
Many people are told they have a “sprain” and are sent home, advised to rest and apply ice. It’s important to identify the cause of the wrist pain, particularly when it persists beyond a week, when grip strength fades, or when the wrist clicks and gives way during tasks. Swelling that keeps returning after use, ongoing pain or tenderness, or a sense of weakness are typical red flags.
People tend to downplay wrist ‘sprains’ and -x-rays can look normal in the early stages. X-rays do not rule out a wrist ligament tear. Subtle instability often becomes obvious only when the wrist is stressed in specific ways. This is where targeted clinical examination and dedicated wrist imaging (like MRI and ultrasound) help. If your work or sport depends on wrist strength, an accurate diagnosis is an essential step in planning appropriate treatment and preventing further deterioration.
Who benefits from specialist assessment
See a wrist surgeon if you:
- had a fall onto an outstretched hand and have persistent pain or tenderness
- feel clicking, clunking or loss of stability in the wrist
- notice grip weakness or pain when you push up from a chair or weight bear on the palm of the hand
- have swelling that comes and goes after activity
We look after adults of all ages, from office workers who struggle using a keyboard to athletes who need stability to perform at a high level. Treatment is personalised. Depending on your symptoms, examination, imaging and demands, non-operative care may be considered. When stability is compromised, timely wrist surgery can protect long-term function.
How we confirm the problem
We start by carefully listening to your history and checking your wrist with a hands-on examination to identify sources of pain and tenderness. We’ll functionally assess any ‘clunks’ or clicking, and check if your wrist feels weaker or gets tired easily. We may also use an ultrasound to assess your wrist during your consultation We often arrange dedicated wrist X-rays including clenched-fist or stress views. These can reveal widening at the scapholunate interval or an abnormal tilt of the scaphoid bone. MRI can show ligament quality, however, small tears can still remain hidden on MRI.
To obtain more information and fully assess the wrist, diagnostic wrist arthroscopy is the gold standard. Arthroscopy uses a small camera to look inside the joint. It lets the wrist surgeon see the ligaments directly, check the cartilage, and assess whether the tear is repairable. Treatment is guided by the type and extent of the tear, as determined by arthroscopy, examination and imaging.
"Examination comes first. Scans add detail. Arthroscopy, when required, gives the most accurate picture inside the joint."
Wrist injury surgery Perth
Surgical options for wrist ligament injuries
When the wrist is unstable, surgery aims to restore alignment, protect cartilage and reduce pain. Options are tailored to the tear location, severity and time elapsed since the injury.
Arthroscopic dorsal capsulodesis
This procedure uses sutures to repair the dorsal capsule and stabilise the wrist through small arthroscopic portals – reducing pain and instability, without a large incision.
If the ligament is torn off the bone, it is sometimes repaired using small anchors and temporary pins to hold the bones while the repair heals. Arthroscopy also allows treatment of other injuries inside the wrist at the same time.
Tendon reconstruction
If it cannot be repaired, your orthopaedic surgeon may use a slip of tendon to reconstruct the ligament. The goal is to hold the scaphoid in an anatomical position and limit abnormal flexion that can cause collapse of the wrist joint.
Partial wrist fusion
In severe longstanding cases,, a partial wrist fusion may be recommended to limit motion, resolve pain and maintain strength.
Depending on the severity and location of the tear, non-operative management (splinting, activity modification or a structured hand therapy programme) may be considered for acute partial tears or low-demand wrists. Your surgeon will discuss the options available to you based on your specific case so you can make an informed decision that matches your goals.
What happens in wrist ligament surgery
"If wrist ligament surgery is needed, we first confirm the issue using a small camera. Then, we do the planned procedure, using special imaging during the operation to make sure it's done precisely."
In the lead up to your procedure, your wrist surgeon will diagnose your injury and discuss what treatment options are available. You will meet the anaesthetist. The wrist is marked to confirm the side and the planned portals. Wrist arthroscopy typically comes first. It confirms the diagnosis. Depending on the location of the tear, the capsule is either fixed with sutures or the ligament is reattached to the bone using anchors. Your surgeon may insert temporary pins to keep the bones stable as you recover.
For reconstructions, your surgeon will discuss with you where the tendon graft will be taken from.
During your procedure, the surgeon may use a special X-ray (called fluoroscopy) to visualise the bones in real-time and ensure they are aligned. After your surgery, you will be referred to for hand therapy, rehabilitation, splinting and post-operative care.
Wrist injury recovery
What wrist ligament surgery recovery looks like
Recovery from wrist ligament surgery depends on the severity and location of your injury, and the repair performed.
- Early phase – weeks 0 to 2. The wrist is protected in a custom thermoplastic splint. Keep the hand elevated and move the fingers and elbow to limit stiffness. Simple nerve and tendon gliding exercises begin under guidance from your hand therapist.
- Protect and heal – weeks 2 to 6. Stitches come out around two weeks. If pins were used, they usually stay until six to eight weeks.. Hand therapy focuses on swelling control, scar management and gentle movement within safe limits.
- Rebuild movement – weeks 6 to 12. As the repair or reconstruction strengthens, guided range of motion increases. Grip and pinch begin with putty and light drills. Office work is often possible earlier, manual roles take longer to return to.
- Strength and function – months 3 to 6. Progressive loading returns. Depending on the injury and surgery performed, people start sport-specific drills around the three to four-month mark if comfort allows. Everyone’s timeline differs. Your programme is adjusted to your progress and job demands.
After a partial wrist fusion, expect a shorter arc of motion but a steadier platform for power tasks. Many patients report confidence with lifting and day-to-day activities once discomfort settles. Your therapist will map out home exercises, brace weaning and milestones. Follow-up visits check progress and address questions promptly.
Balancing benefits and risks
“We explain known benefits and risks clearly and provide written information to support your understanding.”
Dr Humza Khan, Wrist Surgeon
All procedures carry risks. General risks include infection, delayed wound healing, scar sensitivity, stiffness, nerve irritation and blood clots. Procedure-specific issues include pain, loss of motion, hardware irritation, failure of a repair or reconstruction, or non-union after a fusion.
Risk is reduced with careful planning, sterile technique, hand therapy, and a paced return to load. You will receive written information about your operation, expected milestones and who to contact with concerns. If there is a possibility that non-operative care will produce a good outcome in your case, we will say so.
Wrist ligament injuries FAQs
Your questions answered
Do I need a GP referral?
A referral is required to access Medicare rebates (if eligible). If you do not have a GP referral, we offer a bulk-billed Nurse Practitioner service to streamline the process and avoid any unnecessary delays in you accessing treatment.
Will I need scans before I come?
How long until I can drive or work?
What if I am not ready for surgery?
Where are consultations and surgery performed?
Wrist ligament injuries clinic Perth
Taking the next step
If your wrist is still sore or clicking after an injury and you are worried about wrist ligament injuries, contact us to book a consultation.
Bring any X-rays, CT, MRI or ultrasound, your brace if you use one, a medication list and any questions you may have. At the visit, we outline non-operative and operative treatment paths. We provide written information on risks, recovery and follow-up, and connect you with our hand therapy team. Your treatment and rehabilitation plan will be tailored to your specific injury, recovery goals, job and activity levels.