TFCC Liver Case Summary

Mary Elizabeth Seabrook is a 68 year old female who injured her right wrist in an automobile incident on 10-25-15. Her car hit another car who pulled out in front of her. She was initially seen at Bethesda Hospital East ER where she was taken by ambulance. Fractures were ruled out; however she was placed in a splint and was instructed to follow up with a specialist.
On 10-28-15 she presented to my office. She had pain, tenderness, and swelling of her right wrist including severe ecchymosis all consistent with an acute injury. X-rays were taken; this was consistent with scapholunate ligament Injury. An MRI was ordered and she was placed in a splint which she was to keep in place until her follow up.
On follow up her symptoms persisted and her MRI demonstrated TFCC ligament tear as well as scapholunate ligament tear. Risks, benefits, and alternatives were discussed with her. She elected surgery with arthroscopy and arthroscopic repair of the scapholunate ligament and TFCC. Surgery was uneventful, patient did well post-operatively and progressed well. Post operatively however she did report
She did report pain and difficulty performing certain activities of daily living, especially prolonged activities. She is at maximum medical improvement as of this date, 03-07-16. Her permanent impairment rating was calculated based on The 6th Edition of the Guides to the Evaluation of Permanent Impairment published by the AMA. It was determined her permanent impairment was 21% for upper extremity and 13% for whole person. It is possible she may develop pain associated with the click in her wrist in the future, this may require oral over the counter or prescription analgesics, possible intra-articular cortisone injections and may even require surgery in the future to either stabilize the joint or treat arthritis which may develop as a result of the