[Ulnar instability of the carpus]

Area of Science:

• Orthopedics
• Hand Surgery
• Musculoskeletal Research

Background:

• Ulnar carpal instabilities are rare, often overlooked conditions.
• Dissociation of the lunotriquetral (LT) junction is a primary cause.
• Symptoms include ulnar wrist pain, instability, weakness, and clunking sensations.

Purpose of the Study:

• To review the causes, diagnosis, and treatment of ulnar carpal instabilities.
• To highlight diagnostic challenges and emphasize arthroscopy for definitive diagnosis.
• To discuss conservative and surgical management options for LT dissociation.

Main Methods:

• Literature review of ulnar carpal instabilities and lunotriquetral dissociation.
• Analysis of clinical presentations, diagnostic modalities (including arthroscopy), and treatment outcomes.
• Discussion of conservative measures, surgical repairs, reconstructive techniques, and salvage procedures.

Main Results:

• Injuries are the most common cause, but degeneration and ulnar impaction syndrome are also implicated.
• Clinical examination may show LT-interval tenderness and triquetrum displacement; X-rays are often inconclusive.
• Arthroscopy is essential for accurate diagnosis, with treatment options varying from immobilization to complex reconstructive surgeries.

Conclusions:

• Early recognition and accurate diagnosis of lunotriquetral dissociation are crucial for effective management.
• Arthroscopy plays a vital role in diagnosis and can be combined with therapeutic interventions.
• Surgical reconstruction or salvage procedures are often necessary when conservative treatment fails or ligament repair is not feasible.