A sprain is classified as damage or bruising to soft tissue of a surrounding area. This can include, but is not limited to the tendons, which connect muscle to bone; the muscles themselves, ligaments, which connect two or more bones together, or a combination of one or more of these. Minor injuries to the wrist can cause inflammation to the fascia (the soft tissue) and press down on the median and/or ulnar nerve causing significant discomfort as well as potentially reducing the range of motion for the wrist and flanges of the hand considerably. It is important that even if only injury to the fascia is suspected the patient be strongly encouraged to follow up with a physician. This is to rule out bone injury as it is impossible to note the difference upon visual assessment. Muscle testing is not indicated if a sprain is suspected to prevent further injury.
The primary concern with this injury is to reduce swelling and prevent tearing of the ligaments and tendons.
1- Assess the skin for obvious signs of bruising or bleeding that may require primary attention or care when attending to the sprain.
2-Elevate the wrist above the heart of the patient. This will reduce circulation to the area and thus, begin to reduce swelling. This is important in the event that a cold compress is not readily available to assist in the reduction of swelling to the area.
4- Instruct the patient to keep the wrist immobile. As the injury to the wrist is still in the acute phase it is highly susceptible to further injury and possible tearing. Also, before it has been ruled out that no other injuries are present it is important not to assume that there are more injuries or a possible break present.
5- Assess the supplies available for the coldest materials that would provide a topical anti-inflammatory effect. Try to find a soft outer textile like a shirt, towel or paper towel. Do not use anything that will quickly absorb and dissolve in liquid.
Creating a cold compress:
+If there are frozen materials available such as ice, that can be either enclosed in a plastic bag or frozen vegetables in a plastic bag, they also work very well. (TIP: Peas are especially malleable even when frozen and can conform to odd shapes accommodating most body parts for use as a cold compress.) These can be wrapped in the shirt or towel for one kind of compress. Do not place frozen materials directly on the skin.
+If no plastic bag or vegetables are available, ice can be put directly into the shirt or towel for another kind of compress.
+If no ice or frozen material is available, the shirt or towel can be soaked in water of any temperature; although preferably cool, not freezing. The excess water can then be wrung out to let the air naturally cool the material. Then it is ready to be used as a cold compress as well.
6- Apply the cold compress to the wrist lightly. Any cold pack should not be applied for longer than 20 minutes at any given time. The pack should then be removed for 20 minutes and then it can be reapplied. Keeping it on for longer will not be more effective in its anti-inflammatory properties and can damage circulation if left on too long. Continue this cycle for 60 minutes.
7- After the swelling has been reduced it is safe to wrap the wrist loosely, as not to restrict circulation; but firmly in order to support and prevent accidental movement until the patient can be seen and assessed by a medical professional.
-“The Muscles and Fasciæ of the Hand – Gray’s Anatomy of the Human Body – Yahoo! Education.”Yahoo! Education – Dictionary, Colleges, Scholarships, Homework Help, Schools, Reference, Thesaurus & More. 2009. Web. 18 Feb. 2011.
-“Wrist Sprain :: Wrist Dislocation :: SPORTS :: MEDICINE :: NEW DELHI :: INDIA.” Sports Medicine Clinic Delhi :: A Orthopaedic & Sports Medicine Clinic – Arthroscopy – Joint Replacement Surgery – Sport Injuries. Web. 18 Feb. 2011.