Triquetrohamate arthrodesis for midcarpal instability

Arthroscopic Thermal Capsulorrhaphy for Palmar Midcarpal Instability

“…Some of the patients in our series noticed this but felt it was an acceptable trade-off for an improvement in stability. In our study, wrist movement was reduced by a mean of 161 in flexion and 101 in extension; this should not affect the functional range (541 flexion, 601 extension- Ryu et al, 1991) and is less than the reported reductions in movement from limited arthrodesis (Goldfarb et al, 2004;Lichtman et al, 1993;Rao and Culver, 1995).…”

Surgical Treatment of Pediatric Posttraumatic Palmar Midcarpal Instability: Case Report

“…2,8 -11 This may explain the relatively poor outcomes seen with isolated dorsal or volar capsulodesis or single ligament advancement procedures, 12 and the better outcomes seen with midcarpal arthrodeses in adults. 5,12,13 Although ligamentous laxity is common in the pediatric population, PMCI in this age group is believed to be uncommon. Its true incidence, however, may be underestimated because so few patients present with symptomatic instability.…”

“…To the best of our knowledge, only 12 skeletally immature patients have been described in the literature, none of whom was younger than 13 years of age (range, 13-17 y). 4,5 We describe an unusual case of severe chronic, posttraumatic PMCI in a 6-year-old child who was treated with palmar and dorsal capsulodesis and pinning, and we review the literature regarding the surgical treatment of PMCI, particularly in the pediatric patient. …”

Demystifying Palmar Midcarpal Instability

“…It may be alleviated partially by supporting the volar ulnar side of the wrist. 3,25 Patients may spontaneously reproduce a clunk on ulnar deviation, which is often visible and audible to the examiner. This can correct the volar sag, which reappears when the wrist moves back into neutral, with or without another clunk.…”