Ligament injuries

Diagnosis

Tears are usually obvious due to the pain and swelling of the ligament. Our consultants will ask about the events around the injury, and will examine the injured site including comparing the injured muscle against the opposing non injured muscle. If the injury involves a cut, this will usually be examined under local anaesthetic in an operating theatre. Further tests required may include ultrasound, or an MRI. If there is a concern about joint injuries as well as the ligament a CT scan may be requested.

Treatment options

• Watch and wait: Most patients recover well with rest and painkillers.
• Cast: For complete tears a plaster cast or splint may be applied.
• Splinting: If finger ligaments are torn they are often splinted to a neighbouring finger
• Surgery: For the ligaments on the inside, and around the base of the thumb surgery may be required to allow proper healing. Ligament injuries of the wrist may require keyhole surgery to identify the extent of the tear(s) and then be repaired if necessary by the bones of the wrist being held in the optimal position for the ligaments to heal. Ligament injuries to the elbow are usually associated with a break or dislocation, and often repair well by themselves while in a cast. It is uncommon for a ligament repair in the elbow to be required.
  
  Typically performed under local anaesthetic, i.e. making the area numb, but can be performed under a general anaesthetic if requested.
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• Post operative care: Early supervised movement is essential. Most of the movement gained occurs within the first 6 weeks, and so this time is very important for carrying out the prescribed exercises. Return to heavier work may take up to 12 weeks, especially if surgery has been required.

Full movement of the joint is rare after a complete tear, but typically you will gain movement to achieve 90% of tasks that you could complete pre-injury.

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