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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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Metacarpal Small Incision for Carpal Tunnel Syndrome
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Carpal Instability: I. Pathoanatomy.

Rainer Schmitt1,2, Nina Hesse1, Florian Goehtz3

  • 1Department of Radiology, University Hospital LMU, Munich, Germany.

Seminars in Musculoskeletal Radiology
|June 3, 2021
PubMed
Summary
This summary is machine-generated.

Carpal instability involves complex factors affecting wrist stability. Understanding pathoanatomy is key to diagnosing and managing conditions like scapholunate dissociation and midcarpal instability.

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Area of Science:

  • Orthopedics
  • Anatomy
  • Biomechanics

Background:

  • Wrist stability relies on intricate interactions between carpal bones, ligaments, and tendons.
  • Carpal instability arises from disruptions in these structures, leading to dynamic and static forms.
  • Common presentations include scapholunate dissociation, lunotriquetral dissociation, midcarpal instability, and ulnar translocation.

Purpose of the Study:

  • To review the pathoanatomical fundamentals of carpal instability.
  • To elucidate the complex factors contributing to wrist instability.
  • To provide a basis for understanding various instability patterns.

Main Methods:

  • Literature review focusing on pathoanatomical aspects of carpal instability.
  • Analysis of the role of ligaments, joint surfaces, and tendons in wrist stability.
  • Classification of carpal instability into dissociative and nondissociative forms.

Main Results:

  • Carpal instability is multifactorial, involving joint surfaces, intra-articular ligaments (e.g., scapholunate interosseous ligament), and extrinsic tendons.
  • Instability can progress from dynamic to static forms, potentially leading to osteoarthritis.
  • Specific entities like scapholunate dissociation and midcarpal instability are highlighted.

Conclusions:

  • A comprehensive understanding of carpal pathoanatomy is essential for diagnosing wrist instability.
  • Early recognition of dynamic instability is crucial to prevent progression to static forms and osteoarthritis.
  • This review emphasizes the pathoanatomical basis for diverse carpal instability presentations.