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Ligamentous reconstruction for chronic intercarpal instability.

S Z Glickel, L H Millender

    The Journal of Hand Surgery
    |July 1, 1984
    PubMed
    Summary
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    Surgical reconstruction for chronic intercarpal instability improved pain in most patients but led to decreased range of motion. Radiologic improvements were not sustained long-term.

    Area of Science:

    • Orthopedic Surgery
    • Hand and Wrist Surgery
    • Musculoskeletal Research

    Background:

    • Chronic intercarpal instability presents a significant challenge in hand and wrist surgery.
    • Delayed treatment can lead to persistent pain and functional deficits.

    Purpose of the Study:

    • To evaluate the outcomes of surgical interventions for chronic intercarpal instability.
    • To assess the efficacy of different surgical approaches and techniques.

    Main Methods:

    • Retrospective review of 21 patients with chronic intercarpal instability undergoing surgery.
    • Surgical techniques included tendon graft reconstruction and ligament repair via dorsal and/or palmar approaches.
    • Average follow-up was 25.4 months.

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    Main Results:

    • 85.7% of patients reported decreased pain post-surgery.
    • A general decrease in range of motion and a slight increase in grip strength were observed.
    • Initial radiologic improvements were noted but diminished over time.
    • Clinical grade improved from poor to fair, while radiologic grade remained poor with minimal improvement.

    Conclusions:

    • Surgical reconstruction can alleviate pain in chronic intercarpal instability but may compromise range of motion.
    • Long-term radiologic stability remains a concern, necessitating further investigation into durable reconstructive techniques.