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mtomaino 05-03-2012 05:10 PM

Question about chronic wrist pain after wrist dislocation
I received an email this week via the "Contact Dr Tomaino" section of, and wanted to respond:

I need and ask for your help. I had a perilunate wrist dislocatiion 7-1-11 recovered but 6 weeks ago the wrist blew up. had x-ray no new breaks. we hard casted it for 5 week but today the wrist is still 2x+ that it should be. chronic and acute pain that frankly is threatening my mental condition. Not getting help locally.I need help. Please let me know if you are willing to assist.

If you had a perilunate dislocation, and it was not treated with surgery last July, there is a high liklihood that you have residual ligament incompetence (carpal instability). This can lead in short order to painful joint arthritis. This would explain the swelling as well. Even when such injuries are treated acutely with surgery, the intercarpal ligament repairs do not always heal. Your wrist problem is treatable---and usually requires a "salvage" operation----the main objective of which is pain relief. In order to make an assessment of options, perusal of current xrays is necessary. There is hope fo what you are describing. Options include complete wrist fusion, midcarpal fusion with scaphoid excision, and possibly proximal row carpectomy with or without capsular interposition.

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