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Radial Midcarpal Instability Treated with Radioscaphocapitate Ligament Recession: A Case Report
Janice Chin-Yi Liao1, David Meng Kiat Tan2
1Department of Hand and Reconstructive Microsurgery, National University Health System, Singapore, Singapore.
Journal of Wrist Surgery
|January 24, 2024
Summary
This study details a rare case of radial midcarpal instability caused by a radioscaphocapitate ligament injury. Surgical repair led to pain relief and restored wrist function, validating this soft tissue approach.
Area of Science:
- Orthopedic Surgery
- Wrist Biomechanics
- Ligamentous Injury
Background:
- Midcarpal instability presents as wrist pain and clunking during radial to ulnar deviation.
- Management typically involves nonoperative treatment, with surgery reserved for persistent symptoms.
- Surgical options include soft tissue reconstruction or limited midcarpal arthrodesis.
Observation:
- A case of radial midcarpal instability linked to radioscaphocapitate (RSC) ligament injury is presented.
- The patient experienced radial-sided wrist pain and clunking after a fall.
- Arthroscopy revealed an RSC ligament injury causing scaphoid hyperextension and a catch-up clunk.
Findings:
- The patient underwent arthroscopic capsulorrhaphy and open RSC ligament recession.
- This treatment resolved pain and clunking, restoring scaphoid flexion.
- The patient returned to normal activities with excellent outcomes at one year.
Implications:
- This case describes a novel form of radial midcarpal instability attributed to RSC ligament injury.
- The successful surgical outcome validates RSC ligament injury as a cause of radial midcarpal instability.
- Soft tissue repair of the RSC ligament shows promise for treating this specific condition.
