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Related Experiment Videos

Midcarpal instability: is capitolunate instability pattern a clinical condition?

H Ono1, L A Gilula, B A Evanoff

  • 1Mallinckrodt Institute of Radiology, Washington University, St Louis, Missouri, USA.

Journal of Hand Surgery (Edinburgh, Scotland)
|April 1, 1996
PubMed
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Dorsal wrist pain may indicate capito-lunate instability, often missed on standard imaging. Conservative treatments like casting offer limited long-term relief for this midcarpal instability condition.

Area of Science:

  • Orthopedics
  • Hand Surgery
  • Musculoskeletal Disorders

Background:

  • Dorsal wrist pain is a common complaint.
  • Capito-lunate instability is a recognized, yet often elusive, pattern of wrist dysfunction.
  • Standard radiographic and fluoroscopic evaluations may not reveal subtle instability.

Purpose of the Study:

  • To present cases of capito-lunate instability presenting as dorsal wrist pain.
  • To evaluate the diagnostic utility of the dorsal capitate-displacement test.
  • To assess the efficacy of conservative management for this condition.

Main Methods:

  • Case series presentation of five patients with dorsal wrist pain.
  • Clinical examination including palpation for tender points.

Related Experiment Videos

  • Standard radiography and fluoroscopic instability series.
  • Performance of a dorsal capitate-displacement stress test.

    • Main Results:

    • All patients exhibited dorsal wrist pain and tenderness, with variable location and intensity.
    • Plain radiographs and fluoroscopic instability series were normal in all cases.
    • A positive dorsal capitate-displacement test was the primary indicator for capito-lunate instability.
    • Short-term pain relief was achieved in 2/5 patients with casting, but long-term relief was not observed.
    • Only one of three patients with long-term follow-up after casting could return to their original work.

    Conclusions:

    • Capito-lunate instability can manifest as dorsal wrist pain, often undetectable by conventional imaging.
    • The dorsal capitate-displacement test is a valuable clinical tool for diagnosing this condition.
    • Conservative, non-operative treatments, including casting, generally do not provide sustained pain relief for capito-lunate instability.