Culp Midcarpal Reconstruction to Treat Palmar Midcarpal Instability.

Area of Science:

• Orthopedic Surgery
• Wrist Biomechanics
• Reconstructive Surgery

Background:

• Midcarpal instability (MCI) is an uncommon wrist pathology.
• Impaired carpal restraints lead to uncontrolled proximal carpal row movement and a painful "clunk."
• Current non-operative and surgical treatments offer limited long-term benefits.

Purpose of the Study:

• To describe a novel surgical technique for treating palmar midcarpal instability (PMCI).
• To evaluate the efficacy of autograft reconstruction of the radiotriquetral ligament and thermal capsulorrhaphy for PMCI.

Main Methods:

• Surgical intervention for palmar MCI using autograft reconstruction of the radiotriquetral ligament.
• Controlled thermal capsulorrhaphy was performed concurrently.
• Outcomes were assessed in 7 patients.

Main Results:

• The described surgical technique demonstrated lasting symptom relief in patients with PMCI.
• Improved patient-reported outcomes were observed at an average follow-up of 34 months.
• This intervention addresses a rare condition with promising results.

Conclusions:

• Autograft reconstruction of the radiotriquetral ligament combined with thermal capsulorrhaphy is an effective treatment for palmar MCI.
• This surgical approach provides significant and sustained symptom resolution.
• The technique offers a viable option for patients with limited treatment success.