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Traumatic Volar Carpal Instability Nondissociative: A Case Series.

Yibo Li1, Matthew Furey1,2, Armin Badre1,2

  • 1Faculty of Medicine and Dentistry Surgery Department, University of Alberta, Edmonton, Alberta, Canada.

Journal of Hand Surgery Global Online
|December 18, 2023
PubMed
Summary

Carpal instability nondissociative traumatic (CINDT) with volar intercalated segmental instability (VISI) can occur after wrist fractures. This study reports successful non-surgical and delayed surgical outcomes for CINDT-VISI, challenging existing literature.

Keywords:
CINDCarpal instabilityCase reportDistal radius fractureGaleazzi injury

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Area of Science:

  • Orthopedics
  • Hand Surgery
  • Radiology

Background:

  • Carpal instability nondissociative (CIND) results from wrist ligament disruption.
  • CIND traumatic (CINDT) emphasizes post-injury causes and is increasingly studied.
  • Volar intercalated segmental instability (VISI) is a specific type of carpal instability.

Observation:

  • Four cases of CINDT-VISI following surgical treatment of distal radius or Galeazzi fractures are presented.
  • Patients developed CINDT-VISI with significant radiolunate angles post-surgery.
  • Clinical courses varied, including progressive deformity and fixed deformities.

Findings:

  • This is the first report linking Galeazzi fractures with CINDT-VISI.
  • Successful outcomes were achieved with both non-surgical and delayed non-fusion surgical interventions.
  • No radiographic signs of arthritis were noted at 1-2 years post-treatment.

Implications:

  • Nonsurgical and delayed surgical approaches may be effective for CINDT-VISI.
  • The findings challenge the current understanding and treatment paradigms for CINDT-VISI.
  • Early physiotherapy can lead to successful outcomes in some CINDT-VISI cases.