Soft Tissue Stabilization of Midcarpal Instability in Ehlers-Danlos Patients Using a Cadaveric Tendon Graft

Ehlers-Danlos syndrome (EDS) is a group of hereditary disorders that affects collagen synthesis. In the wrist, pain and midcarpal laxity may affect up to 70% of EDS patients. The mainstay treatment of midcarpal instability in patients with ligamentous injury but not EDS includes orthotics, physiotherapy, and activity modification. These methods of conservative treatment may be unsuccessful in controlling instability in the longer term. Using autologous tendon for reconstructing midcarpal instability in patients with EDS carries the risk of loosening over time due to intrinsic abnormalities in collagen metabolism. In this article, we present a novel surgical technique using a cadaveric tendon graft to stabilize bilateral midcarpal instability in EDS patients. A triangular ligament reconstruction from the base of the third metacarpal to the lunate and triquetrum was designed to treat midcarpal instability.