¿Qué es la muñeca abierta? Una aproximación a una lesión muy común.

¿Qué es la muñeca abierta? Una aproximación a una lesión muy común.

Muñeca abierta.Una caída frenada con la mano, un mal golpe o un estiramiento inadecuado al cargar un peso puede traer como consecuencia lo que se ha denominado popularmente como “muñeca abierta”. Ésta, es una lesión dolorosa que tiene un origen ligamentoso y que puede perdurar durante varias semanas o incluso necesitar un tratamiento paliativo. En los casos más complejos, podría ser necesario que quien la sufre pase por el quirófano.

Un fisioterapeuta está perfectamente capacitado para diagnosticar y paliar los efectos de la lesión con diferentes tratamientos rehabilitadores muy efectivos. Esta terapia no conlleva un gran número de sesiones y, por lo general, los resultados que se obtendrán con ella serán muy satisfactorios.

 

¿Qué es la muñeca abierta?

Lo primero que merece la pena explicar es que la muñeca es una articulación bastante compleja, pues es la encargada de realizar diferentes funciones, como la extensión, la flexión, la abducción y la aducción. Simplificando, se puede determinar que esta zona está compuesta por tres articulaciones. Por un lado, la radiocarpiana y, por otro, las externa e interna de la cámara distal de la muñeca. Cada una de estas partes cuenta con sus propios ligamentos que, por lo general, son los que resultan afectados cuando aparece el problema conocido como “muñeca abierta”.

Las lesiones más comunes que afectan a estos ligamentos se producen cuando se frena un golpe o una caída con la mano. Son movimientos en los que se puede producir una torsión, elongación o rotura de estas formaciones que puede llegar a resultar muy complicada de reparar. No hay que olvidar que la muñeca no puede realizar el movimiento de giro, de ahí que cualquier reacción que lo fuerce será susceptible de producir un daño en su estructura.

Dadas las múltiples funciones que ejecuta esta articulación, su lesión causará dolor en muy diversas situaciones. Al ser una zona de tanta complejidad (cuenta con ocho pequeños huesos), una vez se produzca una mínima inflamación se incrementará el dolor, por lo que es normal que durante las primeras horas tras el impacto se recete a la persona un tratamiento con antiinflamatorios.

 

La fisioterapia para paliar esta lesión.

Aunque el tratamiento que determine el fisioterapeuta vendrá dado por el alcance de la lesión ligamentosa, lo normal es que durante las primeras horas la persona que la padece repose y tome antiinflamatorios. En algunos casos podría complementarse con un vendaje, dependiendo de la opinión del profesional. A partir de ahí, podrá emplear una serie de terapias muy comunes para recuperar el buen estado de la zona.

Entre estos, se encuentra la electroterapia, la cual se aplicará en varias de sus formas, como los ultrasonidos o la onda corta. Estas sesiones tendrán un importante efecto analgésico y antiinflamatorio e incrementarán el ritmo de reparación del daño tendinoso.

A medida que pasen los días, o incluso desde los primeros momentos de la terapia -dependiendo del estado del paciente-, se podrán realizar diferentes ejercicios y movimientos flexores y extensores de la muñeca, con los cuales se pretende incrementar principalmente la movilidad de la articulación. El límite de estos ejercicios lo marcará el propio fisioterapeuta, dependiendo de las sensaciones que le transmita el paciente, así como del estado de la propia muñeca que observe.

Otros procedimientos empleados, sobre todo durante los primeros días, tras la lesión, es la terapia de contraste calor-frío, mediante la cual se someterá a la articulación a baños de agua caliente de unos 3 minutos y de fría, aproximadamente 60 segundos, para así conseguir rebajar la inflamación y el dolor. Por supuesto, el estado de los ligamentos también mejorará realizando masajes sobre la zona, otra terapia frecuente. En algunos casos, para disminuir la inflamación, también se recurrirá al drenaje linfático.

Cuando un cirujano determine, podrá recomendar al paciente pasar por el quirófano. En ese caso, el tratamiento fisioterápico comenzará varios días después de la intervención y tendrá el mismo fin rehabilitador.

Ahora bien, la muñeca no sólo puede resultar afectada en sus ligamentos de esta forma, pues también es susceptible de “doler” como consecuencia de una afección común, como es el síndrome del túnel carpiano; o por la fractura -más complicada- de alguno de los ocho pequeños huesos que la conforman. En casos menos frecuentes, puede sufrir otros problemas, como la rizartrosis del pulgar o la tendinitis de Quervain. En todos ellos, el fisioterapeuta siempre podrá emitir un diagnóstico acertado y determinar cuál es el tratamiento más oportuno.

 

Etiquetas: muñeca abierta, ligamento, tendón, tendinitis de Quervain, rizartrosis del pulgar, drenaje linfático, masaje, electroterapia

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