Palmar Midcarpal Instability

Hwang, Michael D.; Klinefelter, Ryan

doi:10.1016/j.jhsa.2012.10.006

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Majority of patients with midcarpal instability respond to nonoperative treatment consisting of activity modification, nonsteroidal anti-inflammatory drugs, and splinting. 3 An ulnar boost splint has been proposed to reduce volar sag in palmar midcarpal instability by providing support over the pisotriquetral area. 9 Our patient had neither a clinical nor radiographic sag.…”

Section: Discussionmentioning

confidence: 99%

“…Soft tissue procedures intended to address the underlying pathomechanics have not been as predictable as salvage procedures, such as arthrodesis. 3 While limited midcarpal or radiocarpal arthrodesis has been shown to have satisfactory results at long-term follow-up, it comes at the cost of significant loss of motion. 1,10 With a better understanding of the pathomechanics, there has been more recent reports of the success in soft tissue procedures.…”

Section: Discussionmentioning

confidence: 99%

“…The reported outcome has not been consistent and has been limited to small retrospective studies. 3 While limited midcarpal fusion has been shown to be more reliable, recent reports have shown success in soft tissue reconstruction by directly addressing the underlying pathology. 4,5 We report the case of a young and active patient with a rare form of midcarpal instability presenting with radialsided pain and clunking during radial deviation.…”

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confidence: 99%

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confidence: 99%

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Radial Midcarpal Instability Treated with Radioscaphocapitate Ligament Recession: A Case Report

Chin-Yi Liao,

Meng Kiat Tan

2023

J Wrist Surg

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Background Midcarpal instability is an uncommon entity characterized by pain and clunking as the wrist moves from radial deviation to ulnar deviation. Management is primarily nonoperative. In patients with persistent symptoms, operative treatments are divided into soft tissue reconstruction and limited midcarpal arthrodesis. Case Description We present a rare case of radial midcarpal instability associated with radioscaphocapitate (RSC) ligament injury. A 20-year-old man presented with radial-sided wrist pain and clunking with radial deviation after a fall. Wrist arthroscopy confirmed the pathology of an RSC ligament injury resulting in an extended posture of the scaphoid and a catch-up clunk from sudden flexion of the scaphoid in radial deviation. His RSC ligament was recessed and he had excellent outcome at 1 year follow-up. Literature Review Midcarpal instability was reported by Lichtman et al as a painful wrist click in ulnar deviation and classified according to the direction of the subluxation. Radial midcarpal instability was later described by Caputo et al in patients with rotatory subluxation of the scaphoid. We present a previously unreported form of radial midcarpal instability as it does not quite fit into the type III midcarpal instability with ligament laxity of the scaphotrapeziotrapezoid joint and type IV with scapholunate ligament disruption. The painful wrist click occurs in radial deviation as the result of an RSC ligament injury. Clinical Relevance We performed arthroscopic thermal capsulorrhaphy of the ulnar arcuate ligaments and dorsal capsule and an open proximal recession of the RSC ligament. The elimination of pain and clunking accompanied by the restoration of scaphoid flexion and return to load-bearing activities validates the pathology and suggests the potential of this soft tissue procedure in the treatment of radial midcarpal instability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Radial Midcarpal Instability Treated with Radioscaphocapitate Ligament Recession: A Case Report

Chin-Yi Liao,

Meng Kiat Tan

2023

J Wrist Surg

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“…This is mirrored in the literature. Education to avoid aggravating activity that causes the pain, click or clunk has been recommended by a number of authors (Chinchalkar and Yong, 2004;Garcia Elias, 2008;Hwang and Klinefelter, 2013;Lichtman et al, 1981;Lichtman and Wroten, 2006;Ritt, 2004;Wolfe et al, 2012;Wright et al, 1994). This is a simple but important concept.…”

Section: Basic Therapymentioning

confidence: 99%

Conservative management of midcarpal instability

Harwood

Turner²

2015

J Hand Surg Eur Vol

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Midcarpal instability is a complex condition that can present in various forms, from mild pain to debilitating subluxation. Once diagnosed, treatment guidelines for hand therapy are limited by the scarcity of high-level evidence. Evidence does exist for use of proprioceptive awareness and neuromuscular rehabilitation for instability of the knee, shoulder and ankle joint, but studies of similar programmes for the wrist joint have not been published. The purpose of this review is to examine the evidence supporting current concepts in the non-operative management of midcarpal instability, and to provide recommendations for the management of this condition with hand therapy.

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Dorsal Wrist Plication for Midcarpal Instability

Schroeder

2018

The Journal of Hand Surgery

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Palmar Midcarpal Instability

Cited by 4 publications

References 11 publications

Radial Midcarpal Instability Treated with Radioscaphocapitate Ligament Recession: A Case Report

Radial Midcarpal Instability Treated with Radioscaphocapitate Ligament Recession: A Case Report

Conservative management of midcarpal instability

Dorsal Wrist Plication for Midcarpal Instability

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