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Chronic capitolunate instability.

R P Johnson, G F Carrera

    The Journal of Bone and Joint Surgery. American Volume
    |October 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Chronic wrist pain and instability following injury can be caused by radiocapitate ligament insufficiency. Surgical tightening of this ligament can stabilize the wrist, though with some loss of motion.

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    Area of Science:

    • Orthopaedic Surgery
    • Wrist Biomechanics
    • Trauma Surgery

    Background:

    • Chronic wrist pain, weakness, and clicking after remote dorsiflexion injury are common.
    • Standard orthopedic examination and plain radiographs may not reveal the underlying pathology.

    Purpose of the Study:

    • To identify the cause of chronic wrist symptoms after remote injury.
    • To evaluate the effectiveness of surgical intervention for radiocapitate ligament insufficiency.

    Main Methods:

    • Twelve patients with chronic wrist symptoms underwent dorsal-displacement stress testing under fluoroscopic guidance.
    • Eleven patients underwent surgical repair involving tightening of the volar radiocapitate ligament.
    • Outcomes were assessed using objective and subjective criteria with an average follow-up of over four years.

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    Main Results:

    • Dorsal subluxation of the capitate and instability of the lunate were identified as key findings.
    • Surgical tightening of the radiocapitate ligament stabilized the capitate and lunate.
    • Good to excellent results were achieved in nine out of eleven surgically treated patients.

    Conclusions:

    • Insufficiency of the radiocapitate ligament is a cause of chronic symptomatic capitolunate instability following wrist trauma.
    • Surgical shortening of the radiocapitate ligament is an effective treatment for stabilizing the lunate and capitate.
    • While effective, the procedure may result in a slight loss of wrist extension and flexion.