Just one example of complications

Author Subject: Just one example of complications
Tarzan Posted At 14:04:25 01/19/2001
Main Menu Home Page
Chronic capitolunate instability.
Johnson-RP; Carrera-GF
J-Bone-Joint-Surg-Am. 1986 Oct; 68(8): 1164-76
Twelve patients, twelve to thirty-two years old, were evaluated for
complaints of chronic vague pain, weakness, and clicking in the wrist
that had followed a significant but remote dorsiflexion injury to the
wrist. Although a standard orthopaedic examination and plain
roentgenograms of the carpus were unremarkable, a dorsal-displacement
stress test done under fluoroscopic control with the radius fixed
showed dorsal subluxation of the capitate out of the cup of the
lunate, accompanied by a marked feeling of apprehension by the
patient. This was also associated with a painful snap or click due to
a sudden dorsal attitude and ulnar shift of the lunate, best elicited
with the wrist in slight ulnar deviation. We believe that this
condition is due to attenuation of the radiocapitate ligament
resulting from prior trauma. Eleven patients were operated on. The
volar radiocapitate ligament was tightened by tethering its central
portion to the radiotriquetral ligament, partially obliterating the
space of Poirier. Slight extension of the wrist was lost by this
procedure, but the capitate could no longer be passively displaced and
the lunate became stable. Using both objective and subjective
criteria, six patients had an excellent result; three, good; one,
fair; and one, poor. There was an average final loss of 15 degrees of
extension and 19 degrees of flexion of the wrist. The average length
of follow-up was four years and four months (range, twenty-four to 109
months). We concluded that insufficiency of the radiocapitate ligament
after trauma to the wrist is one cause of chronic symptomatic
capitolunate instability. Shortening of the radiocapitate ligament is
recommended to stabilize the lunate and capitate.

Post Reply:

This message board has been closed in regard to posting new messages and follow-ups although pages can be viewed. Page loading time had become excessive. Please use the "Message Forum" link from our Main Page here to contribute to our new and improved forum.

[ To the IW Forum | Forum FAQ ]