Wrist Injury | TFCC, Lunotriquetral Ligament, Ulnotriquetral, VISI Deformity

I want to document my injury and recovery and thought this would be a good place. I know I've spent hours looking for people in similar situations, but never really found the info I was looking for. I hope this helps someone else down the road.

What happened?
12/30/2015 I was at the climbing gym. I was on a problem that involved me cutting my feet while my upper body was leaning over onto a single large angled pincher to my right. As my feet cut, my right hand held taking most of the momentum as my body swung out from under me. My wrist torqued and I heard a pop as a fell. It didn't hurt as much as it felt uncomfortable. I continued to climb not having any pain, but noticed some instability in my wrist.

That night I woke up in the middle of the night with a throbbing pain in my wrist. Unable to sleep I wrapped my wrist up in a tight bandage. I waited a few days hoping it was sprained before getting it checked out

1st diagnosis
1/10/2016 - Got some x-rays and went to a wrist specialist that was covered by my insurance. He looked at the x-rays, felt my wrist, and told me there's some instability in my wrist. He gave me a WristWidget to wear. I asked if it would heal on it's own, he responded 'maybe' and that we'll need to wait and see. I really think he was having a bad day and took it all out on me because he didn't schedule and followups with me, nor did he order an MRI.

2nd diagnosis
2/18/2016 - After wearing the wrist widget for a few weeks I decided to see another specialist. The wristwidget helped very much with the pain, but I felt short changed from the sh*tty doctor visit. I had seen this hand specialist years earlier for other wrist related issues. I originally hesitated this time around because he's out of my insurance network. He's known as 'The Best Hand Surgeon' in NYC.

After multiple tests he told me I likely had a TFCC tear and a possible Lunotriquetral ligament tear. He also mentioned a possible VISI Deformity after comparing my x-rays to older ones that I had on file from prior visits. He went over treatment with me which could include either arthroscopic surgery or cortisone shots. If there were a ligament tear as well, surgery would be a bit more involved though we didn't go into details. He ordered me to get an MRI.

Thoughts
I've done a bunch of reading about TFCC tears and it sounds common, though symptoms may still linger after surgery. I'm not familiar with what would be the outcome/recovery of surgery on the Lunotriquetral ligament, but it sounds more involved than a TFCC tear. I think he mentioned that would be related to the VISI deformity, but really I don't know. I very much trust this doctor and am very glad I went for another opinion. In all honesty, I should have gone to him a from the beginning, but medical costs can build up quick.

My MRI should be early next week. I'll keep this updated and let ya'll know how it goes. If anyone has questions, or stories from their own experiences, that would be great help. It's my dominant hand which would make recovery a bit problematic. I can function day to day, but need to be careful turning keys, opening doors, and putting weight on my hand when getting up (mantle position).

I had a TFCC tear, along with some ligament damage with it whilst grabbing a hold with my wrist bent towards my pinky - sent a sharp jolt of pain up my arm, but I finished the climb. I left it a year hoping it would sort itself out, it didnt.

X-rays were useless, got dye injected and an mri. The dye leaked out of the joint which is apparently characteristic of tfcc tears.

Got the tear stitched up. Surgeon found the joint cartilage was a bit damaged aside from the tear so he cleaned it up - he wasn't expecting that so i guess the MRI isn't all that detailed a view in. Apparently you can have extensive damage in wrists and not really feel it.

That was maybe 4 years ago that i did the injury. I've had a few minor issues in that region of both wrists since. Can't do pushups anymore, and when climbing have to be conscious of wrist alignment and tape wrists all the time. Sharp pain isn't uncommon

Curiously for me pullups and weighted pullups are fine. I got a bit into aid when injury was worse, I'd like to get into mixed climbing - more aggressive the axe the better, the bending that straighter axes cause me feels like impending doom.

TFCC injuries tend to come with not the best recovery prospects. Good news is my hand has always worked, it just hurt a lot.

I envy those people complaining of tendon injuries... I've never had one, but it must be a joyous thing to have tendons that blow before ligament and cartilage. I'm relatively flexible and thin, had the injury when I was around 26. I don't imagine there will ever be the day where I'll be able to free climb and not think about it.

Good luck!

Had a central TFCC tear in 2008 due to a wrist subluxation while climbing (I have loose joints, the wrist is one of my most unstable). After 3! hand surgeon opinions, had debridement surgery and recovered essentially fully. Luckily my joint was otherwise in good condition except for an inflamed synovium (incidentally the synovectomy was the most painful thing to recover from).

Like r m, though, I never "don't think about it". Tape both wrists every time I climb with a dual compression method like the wrist widget provides. Avoid hard slopers. I can do push ups and all sorts of things I never thought my wrist would do again during the injury. Occasionally I get pain again on the tip of the ulna after climbing or doing other weird things lifting heavy objects; this alarms me and I usually take it easy for a bit after that. I never push it on plastic or even on rock just to "look good" either. I totally avoid certain types of climbing and have modified things like training on a hangboard (let's just say progression is difficult).

Surgery took me from totally handicapped to fully functional again. I have a partner who also had a TFCC tear; in his case conservative treatment worked (it didn't for me), but he also tapes and takes care of the wrist while climbing.

feder04,
You said that you hope this helps someone else down the road.

um.....? it would be nice of you to share with us which of the Best Hand/ Wrist , Orthopedics Departments
you have been to, and have decided to use.

Please, this is a subject that I think is going to be an increasingly
relevant subject.

Each of these rank very highly. It depends on some personal stats. as to which one might deliver you
the best care.
Pre-op, actual procedures( aggressive vs Conservative)
Post op, fixed casting vs immediate movement.
Are just the top of the list off things to consider.

NYU

Hospital For Special Surgery

Or,

Columbia Presbyterian/ / Cornelle ,Wiel

To followup with my original post.

After getting an MRI it was confirmed that I tore both my lunotriquetral and ulnotriquetral ligaments. My TFCC is fine, no damage, so it could always be worse and I could have injured that too.

Doctor recommended I stay in a splint religiously for another 2 weeks, then adjust the schedule that I have the splint on to only wear it when I'm sleeping, commuting, or actively moving.

I have a followup appointment in a month to discuss surgery if the symptoms do not subside.

It's a bit nerve wrecking thinking about surgery. There's always the risk of coming out worse than you are prior which is stuck in my head.

I guess I'm wondering if I would have been better off with just a TFCC tear? No reason to think that way really. Does anyone have experience with surgery and recovery from a ligament tear?

feder, your surgeon is doing the right thing by attempting conservative treatment first. If that fails, you are a better surgical candidate.

I understand being scared of the knife. I also felt similarly. It did not help that you read stories of people who claim their surgeries created more pain/worse outcomes. No treatment has a 100% success rate. I had read horror stories of TFCC surgery on the (stupid fucking) Internet ;) + I had two close friends/family in the healthcare business telling me not to do it, but after having my entire left arm handicapped (in every way, not just climbing) for 9 months, I was ready for surgery. I picked a good surgeon and had a great outcome in the long run. Is my wrist exactly as good as before? No, but it is very good.

Every type of injury has a spectrum of pain and debilitation, so I am not sure you can conclude your ligament tears are worse than a TFCC tear (mine was pretty completely debilitating). There are more variables to a "bad injury" than just a) or b).

Get another opinion if surgery seems likely and you think it might help qualm your fears. I had three due to conflicting views from the 1st two.

Don't be too scared of wrist surgery, for my TFCC tear the dr didn't even give me a sick certificate! Once I woke up from general, I went back to work. Didn't get much done that day admittedly.

It sucks having to wipe your ass with the other hand, and self-inflating sleeping mats become the spawn of the devil, but apart from that things weren't too bad.

It is only a hand. You have two of them. Worst case is you'll become an aid climber, which isn't that bad.

Resurrecting an old thread here.

I've been having trouble with my wrist subluxing when I'm on giant holds, usually on relatively easy ground. It's mostly happening when my wrist is in a little flexion. Happened 3 times last year and once again last night. So freaky and disturbing.

Has anyone dealt with that?