Carpal instability of the wrist

The scaphoid is stabilized by the scapholunate ligament (directly) and lunotriquetral ligament (indirectly). Disruption of either of these ligaments leads to a pattern of instability that, left untreated, leads to altered mechanics of the wrist and ultimately debilitating arthritis and collapse. Although arthroscopy remains the gold standard for diagnosis of these injuries, plain films and advanced imaging are useful adjuncts. In the acute setting, conservative treatment may be attempted, but recalcitrant cases require surgical stabilization. Salvage procedures are also available for those patients who fail initial stabilization or present with late degeneration.