Carpal Instability
The bones of the wrist have no muscular attachment. Wrist stability comes primarily from many strong ligaments, all with the primary goal to stabilize the wrist joint. Damage to any of these
ligaments may result in movement of the carpal bones (scaphoid, lunate, triquetrum) resulting in an unstable environment, or carpal instability.
Scapholunate Instability is among the most common ligamentous injury of the wrist. It is the result of significant damage to two of the three main ligaments that bind the lunate and scaphoid
bones. These ligaments include the volar radioscapholunate ligament, the scapholunate interosseous ligament, and the dorsal scapholunate ligament.
The early symptoms of a ligament injury resulting in carpal instability include pain, weakness and a sense of "giving way." Often times the pain will subside after a few days even though
carpal instability persists. Unfortunately, this reduction in pain leads patients to believe that a physical examination and subsequent treatment plan are unnecessary.
If left untreated, carpal instability could cause abnormal wear and tear on the joint and eventually lead to osteoarthritis.
Risk Factors
Carpal instability and ligament injuries prompting this condition occur more often in the young and middle- aged, as a result of their level of activity and bone
strength. Injury to the increasingly fragile bones of older patients most often results in a fracture rather than soft tissue damage and discreet instability.
Treatment
Carpal instability is confirmed following a physical examination, assessment of the manner in which the injury was incurred and imaging scans.
Carpal instability, if left untreated, can result in further shifting of the carpal bones. In the case of scapholunate instability, the continuation of shifting can eventually lead to a
condition known as scapholunate advanced collapse, or SLAC. |
