Until recently, wrist injuries with normal radiographs were referred to as wrist sprains and were treated conservatively with a splint. The popularity of MRI, CT-arthrography, and wrist arthroscopy has made them available in emergency settings and has enabled early diagnosis of ligament or bone injuries. Some authors propose early wrist arthroscopy to explore and repair the injuries. The main purpose of this study was to report mid-terms outcomes of wrist sprains in a more diverse population. The primary hypothesis is that the medium-term results of the conservative treatment are satisfactory. The second aim of this study was to identify criteria predictive of poor functional outcome.

Patients with normal radiographs after review treated with wrist splint were included in the study. The primary outcome was the functional prognosis at the last follow-up. Secondary outcomes were the relationship with numerous criteria and the functional outcome. Those criteria were sex, age, involvement of the dominant limb, work-related injury severity of the initial trauma (more or less kinetic than a fall from one's own height), initial post traumatic pain, swelling of the wrist, length of the immobilisation, compliance with prescribed treatment, secondary imaging result, adjuvant treatment: physiotherapy, infiltration, surgery.

50 patients were included. Mean follow-up was 2.1 years. Mean QuickDASH was 1.3. Mean Pain was 0 on a scale from 0 to 10. Worse functional outcome was associated with work-related injury.

Conservative treatment using wrist immobilisation gives good results in most cases. Patients who remain in considerable pain during the week should undergo additional imaging to rule out any undetected past fractures. Patients who remain in pain after 4 to 6 weeks of immobilisation should seek specialist advice.

Conservative treatment of wrist injuries with normal radiographs is reliable treatment with excellent outcomes. Imaging and surgery should be reserved for patients with persistent pain one month post-trauma.