Carpal instability

Uncommon Patterns of Carpal Instability

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Carpal Instability Nondissociative (CIND)

Definition Mcq ❓️

• Instability between carpal rows without disruption within the same row.
• Types:
  • Radiocarpal Instability.
  • Midcarpal Instability.
  • Combined Instability (radiocarpal + midcarpal).

Management

1. Conservative:
   • Splinting.
2. Operative:
   • Open repair with pinning.
   • Midcarpal fusion.
   • Wrist fusion for severe cases.

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Radiocarpal Instability

Causes

1. Bony:
   • Fractures of the radial or ulnar styloid.
2. Ligamentous:
   • Injury to palmar or dorsal radiocarpal ligaments.

Associations

• High-energy trauma.
• Acute carpal tunnel syndrome.
• Acute compartment syndrome.

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Axial Instability

Definition

• Instability involving axial alignment of the carpus.

Causes

• High-energy trauma.
• Capitate-hamate dissociation.

Associations

• Neurovascular injury.
• Musculotendinous injury.

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