Presentation
CONCLUSIONS: Patients with STT arthritis may present with carpal instability that is not related to radiographic scapholunate instability. [ncbi.nlm.nih.gov]
Entire Body System
- Collapse
Scapholunate advanced collapse. J Surg Orthop Adv 2015;24(2):140-143. Shah CM, Stern PJ. Scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist arthritis. Curr Rev Musculoskelet Med 2013;6(1):9-17. [jaocr.org]
[…] of stability of the central column present only during ulnar or radial deviation (dynamic DISI and VISI), and triquetrolunate, producing the loss of the dorsiflexion influence of the triquetrum on the lunate and, consequently, a static type of VISI collapse [ncbi.nlm.nih.gov]
Musculoskeletal
- Wrist Pain
Signs of carpal instability were assessed on static and dynamic radiographs of the wrist obtained in 72 patients (24 female, 48 male; mean age, 36 years; age range, 14-59 years) with posttraumatic wrist pain. [ncbi.nlm.nih.gov]
Instability in the ulnar carpal wrist may present with pain, swelling, and tenderness in the ulnar aspect of the wrist. [3pointproducts.com]
Stabilization of the axial instability by capitohamate arthrodesis relieved the chronic wrist pain. [mayoclinic.pure.elsevier.com]
Workup
[…] lateral border of the anatomical snuffbox) Colles' Fracture Scaphoid Fracture C6-C7 Radiculopathy Non-Specific Wrist Pain Mechanical Wrist Pain – Individuals who have symptoms suspicious of scapholunate instability with unremarkable findings on further workup [physio-pedia.com]
Treatment
This study examined the incidence of static radiographic signs of carpal instability in patients with distal radial fractures before and after fracture treatment. [ncbi.nlm.nih.gov]
Lunotriquetral instability There is no consensus on the appropriate treatment of lunotriquetral instability. The treatment algorithm can probably be based on the type and age of the injury. [emedicine.medscape.com]
When carpal instability does not respond to conservative treatments, surgical treatments are the best option. Physical therapy is used to regain movement and flexibility post-surgery. [handsport.us]
Prognosis
[…] radius malunion is the most common cause may be purely ligamentous or have associated ulnar and radial styloid fractures Associated conditions intracarpal injury (scapholunate or lunotriquetral ligament) acute carpal tunnel syndrome compartment syndrome Prognosis [orthobullets.com]
Prognosis: Volar dislocation more severe than dorsal. Carpal Instability 33. [slideshare.net]
[…] of reduction by radiolunate arthrodesis more reliable Dynamic VISI & DISI trial of nonoperative management with AEPOP/ NSAIDS/ local injection of steroids Stabilisation of midcarpal joint limited fusion Capsuloligamentodesis tenodesis Complications Prognosis [orthofracs.com]
Rehabilitation is often prolonged, and the prognosis depends mainly on the severity of soft-tissue damage PowerPoint Presentation: Treatment Options for Wrist Ligament Injuries and Instability Acute wrist ligament injuries : closed or arthroscopically [authorstream.com]
This pattern of ulnar translocation, in reality, represents a severe form of scapholunate dissociation and carries a worse prognosis. 19 Figure 19: T1-weighted coronal image demonstrates ulnar translocation of only the lunate (L) and triquetrum (T) bones [radsource.us]
Etiology
The evaluation of this new type of carpal instability with radiographs, tomography, arthrography, and magnetic resonance imaging failed to demonstrate its etiology. [mayoclinic.pure.elsevier.com]
Etiology wrist trauma, with or without a fracture scaphoid fracture : bony DISI distal radius fracture : compensatory DISI radius malunion: adaptive DISI scapholunate ligament dissociation : ligamentous DISI Fixed DISI deformity only occurs after combined [radiopaedia.org]
Epidemiology
Introduction Defined as instability between rows (either radiocarpal or midcarpal) radiocarpal instability (between radius and proximal row) midcarpal instability (between proximal and distal row) Epidemiology incidence rare Pathophysiology and Mechanism [orthobullets.com]
Sprain of carpal joint of unspecified wrist, initial encounter A- initial encounter D- subsequent encounter S- sequela Scapholunate Instability ICD-9 842.01 Sprains and strains wrist and hand; wrist; carpal (joint) Scapholunate Instability Etiology / Epidemiology [eorif.com]
[…] of carpal bones is lost Aetiology DISI due to disruption of scapho-lunate articulation VISI secondary to disruption of lunate & triquetral Ulnar translocation rarely results from injury but is commonly seen in wrists affected by rheumatoid arthritis Epidemiology [orthofracs.com]
Although nearly 30% of all injuries are wrist injuries, there is a lack of epidemiological data available on carpal instability. [7] [LoE:5]. [physio-pedia.com]
Pathophysiology
Introduction Defined as instability between rows (either radiocarpal or midcarpal) radiocarpal instability (between radius and proximal row) midcarpal instability (between proximal and distal row) Epidemiology incidence rare Pathophysiology and Mechanism [orthobullets.com]
The book begins with a basic science section on pathophysiology of the hand, wrist and forearm. The rest of the two-volume book then follows a progressive organization from the most common problems to the least common problems of the hand. [books.google.ro]
The two main reasons for this are that MCI is a mixed bag of conditions, and that their pathophysiology is not well understood. The management of MCI remains controversial. Table 42-1 provides a summary of MCI. [clinicalgate.com]
Log In or Register to continue Nov 16, 2016 | Posted by in ORTHOPEDIC | Comments Off on Kinematics and Pathophysiology of Carpal Instability [musculoskeletalkey.com]
Prevention
Prevention of nonunion involves early attention to the therapy of carpal instability when associated with scaphoid fracture. [ncbi.nlm.nih.gov]
“And the best way to prevent both of those is to try to obtain more anatomic reductions.” [healio.com]
With complete SLIL tears, cast immobilization does not reduce or prevent scapholunate diastasis. [45] Significant force occurs at the scapholunate interval on wrist loading. [emedicine.medscape.com]