Wrist Instability After Injury

Abstract

Fractures of the bones that make the wrist joint together with injury to the ligaments and joint capsules are frequent traumas. It can cause besides limited movement also the pathological mobility. These mild injuries often do not provide the degree of recognizable symptoms and signs. They are diagnosed by X-ray imaging, stress images. Before arthrography was an important method, but nowadays arthroscopy has the advantage. Fresh bone and ligament injuries can be and should be repaired in the early posttraumatic period. Unrecognized and undiagnosed injuries are leading to instability of the wrist, to motion abnormalities or impingement overload syndrome. In the treatment of instability important place have reconstruction of the ligaments and arthrodesis of the wrist.

Physiotherapeutic Management for Acromioclavicular Joint Sprain With Volar Intercalated Segment Instability at the Wrist: A Case Report

“…Early diagnosis can result in conservative management via physical therapy rehabilitation; other options can range from closed reduction and Kirschner wire fixation to tenodesis, arthrodesis, etc. [ 22 ].…”

Magnetic Resonance Arthrography of the Wrist and Elbow

“…Ulnocarpal impaction is usually seen in the setting of positive ulnar variance, either congenital or posttraumatic, with distal radial malunion. 16,17,24 The TFC is thinner in patients with positive ulnar variance and loading of the ulnar carpus is increased, both factors that may predispose to increased rates of TFCC pathology. 11,17,21 Increasing the ulnar variance by 2.5 mm will increase the ulnar load by 42%, more than twice the normal amount.…”

“…Disruption of the secondary triquetral stabilizer, the radiolunotriquetral ligament, predisposes to volar intercalated segmental instability, in which there is palmar rotation of the lunate and scaphoid. 16,17,24 Magnetic Resonance Arthrography Accuracy: Lunatotriquetral Ligament…”

“…16,24 Although carpal instability may be suggested radiographically in cases of static instability, patients will invariably undergo MR imaging for evaluation of dynamic instability and treatment planning. DISI is one of the dissociative instabilities that occurs when there is disruption of the SL.…”

“…Disruption of the secondary stabilizers of the scaphoid leads to rotation of the scaphoid with proximal subluxation, as well as dorsal extension of the lunate, resulting in dorsal intercalated segmental instability (DISI). 1,16,17,24 Magnetic Resonance Arthrography Accuracy: Scapholunate Ligament…”