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Wrist Whiplash Injuries

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Inside  Whiplash Wrist Injuries
[ Up ] [ Cervical Whiplash Injuries ] [ Lumbar Whiplash Injuries ] [ Wrist Whiplash Injuries ] [ Headaches Following Whiplash ] [ MTBI ] [ Factors Delaying Recovery ] [ Whiplash Flare-ups ] [ Risk Factors for Injury ] [ Side Impact Collisions ] [ Common Prescriptions ]

Anatomy

Symptoms

Diagnostic tests

Treatment

Rehabilitation

Risk factors / prevention

Nutrition and supplements

Flare-ups

Chiropractic & Medical research

 

Wrist Injuries from Automobile Crashes

Wrist injuries (including carpal tunnel syndrome - CTS) are commonly seen following motor vehicle crashes. The symptoms include the following:

1) Intermittent (nighttime) abnormal sensation, numbness, (and sometimes burning and tingling) in the 1st three digits of the hand (early stage). 

2) Persistent abnormal sensations and numbness in the 1st three digits of the hand (intermediate stage). 

3) Permanent impairment of sensory and motor function of the hand; atrophy of some hand muscles; pain (advanced stage).  

The double crush phenomenon was first described by Upton and McComas in 1973. It is now a widely accepted theory. Any peripheral nerve can be subjected to double or multiple crushes. The reverse double crush was described by Carroll and Hurst in which patients with symptoms of Thoracic Outlet Syndrome were cured by decompression of the carpal tunnel.

While a genetic predisposition has recently been proposed, the most common etiologies of CTS are cumulative trauma, the use of vibration tools (which can include recreational use of weed whackers and leaf blowers), and intrinsic sources of compression (lunate or scaphoid subluxation or arthritis of the thumb). Estrogen depletion has also been implicated and should be considered in menopausal women or those who have had their ovaries removed.

The postulated mechanism behind the development of CTS has often been attributed to some combination of double or multiple crush and/or direct trauma to the median nerve as a result of holding the steering wheel of a car at the time of injury. 

Onset of Symptoms

Coert and Dellon reported 2 patterns in the onset of carpal tunnel syndrome (CTS),

bulletone group becoming symptomatic within 1 week
bulletthe other from 1 week to more than 6 months, and considering perineural fibrosis, 2 years.

The diagnosis of CTS rests primarily on careful history taking and physical examination.

 

 
 
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