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Chapter-216 Carpal Instability

BOOK TITLE: Textbook of Orthopedics & Trauma (4 Volumes)

Author
1. Warrier Sudhir
ISBN
9789385891052
DOI
10.5005/jp/books/12869_217
Edition
3/e
Publishing Year
2016
Pages
10
Author Affiliations
1. 204, Silver Nest, Sardar Vallabbhai Patel Nagar, Andheri (W), Mumbai, Lilavati and Jaslok Hospitals, Mumbai, Maharashtra, India, Lilavati, Hinduja, Jaslok, Shushrusha, Sportsmed and Sunridges Hospitals, Laud Clinic, Mumbai, Maharashtra, India
Chapter keywords
Carpal instability, dorsal intercalated segment instability, DISI, volar intercalated segment instability, VISI, scapholunate dissociation, scapholunate articulation, scapholunate ballottement test, SLAC wrist, lunotriquetral Instability

Abstract

Carpal instability is defined as any misalignment of the carpus. This may be evident on plain radiography as a static deformity; alternatively, the situation may be a dynamic one, which becomes evident only when external forces are placed on the wrist. All carpal injuries that one comes across in the emergency room cannot be satisfactorily slotted into the commonly used classifications. The Mayo classification for Carpal instabilities is comprehensive and currently accepted. The simplest way to suspect this carpal instability dissociative (CID) variety of wrist instability is to look at the scapholunate interval in a PA view of the wrist. The scaphoid is the important link between the proximal and the distal carpal rows. It provides vertical and transverse stability through its articulations. Scapho-lunate advanced collapse (SLAC) wrist, lunotriquetral instability, lunate-related dislocations, midcarpal instability and triquetrohamate instability are the other important topics of this chapter which are discussed in detail.

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