A Systematic Approach To A Painful Wrist（一套系统的方法来一个痛苦的手腕）.pdf

A Systematic Approach To A Painful Wrist Although wrist injuries are not life threatening, they are of great importance in terms of how they can affect daily functioning. Without an accurate diagnosis, treatment of wrist pain becomes increasingly difficult. By Robert Wang, BSc; Jeremy Reed, MD; James Leone, MD; Mohit Bhandari, MD, MSc; and Jaydeep K. Moro, MD, FRCSC rist pain is a serious problem in Anatomy of the Wrist Wterms of morbidity, since it often The bony anatomy of the wrist consists of the leads to functional disability. The causes distal radius, distal ulna and the carpal bones. of wrist pain are diverse and present as The distal radioulnar, radiocarpal and ulno- difficult diagnostic and therapeutic chal- carpal joints form the proximal border of the lenges. It is important, therefore, to have a wrist. The eight carpal bones demarcate its clear approach when assessing wrist pain distal border (Figure 1). in order to make consistently accurate The ligaments that stabilize the wrist joint diagnoses. The purpose of this article is to are grouped into three regions. First, the tri- provide a systematic approach in evaluat- angular fibrocartilage complex (TFCC) ing adult wrist pain. attaches the distal radius, lunate and tri- quetrum to the distal ulna1 (Figure 2). 86 The Canadian Journal of Diagnosis / August 2001 Painful Wrist Second, the interosseous intrinsic liga- ments which conne