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Related Experiment Videos

Intercarpal arthrodesis for static and dynamic volar intercalated segment instability.

T Trumble1, C J Bour, R J Smith

  • 1Department of Orthopaedics, Yale University School of Medicine, Orthopaedic Section, New Haven, CT 06510.

The Journal of Hand Surgery
|May 1, 1988
PubMed
Summary
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Surgical treatment for volar intercalary segment instability (VISI) involving intercarpal arthrodesis relieved wrist pain and improved function in most patients. Arthrodesis of both proximal and distal carpal rows yielded better outcomes than proximal row fusion alone.

Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Biomechanics

Background:

  • Volar intercalary segment instability (VISI) is a condition characterized by wrist pain and a palpable "clunk" during ulnar deviation.
  • This instability involves abnormal rotation of the proximal and distal carpal rows, confirmed by arthrograms and cineradiography.

Purpose of the Study:

  • To evaluate the effectiveness of intercarpal arthrodesis in treating patients with volar intercalary segment instability (VISI).
  • To compare the outcomes of different arthrodesis techniques for VISI.

Main Methods:

  • Seven patients with VISI underwent surgical intervention, primarily intercarpal arthrodesis.
  • Procedures included capitate-lunate-triquetrum hamate (CLTH), lunate-triquetrum (LT), lunate-triquetrum-hamate (LTH), and triquetrum-hamate (TH) fusions.

Related Experiment Videos

Main Results:

  • Arthrodesis of both proximal and distal carpal rows relieved wrist pain in five out of six patients.
  • One patient with proximal row arthrodesis alone had a poor outcome.
  • Successful cases showed significant restoration of wrist motion and grip strength.

Conclusions:

  • Intercarpal arthrodesis, particularly involving both proximal and distal carpal rows, is an effective treatment for volar intercalary segment instability (VISI).
  • The surgical approach should aim to stabilize both carpal rows for optimal pain relief and functional recovery.