Wrist Instability

Excerpt

The wrist is a highly complicated and adaptable structure. Many small carpal joints enable significant motion in the coronal and sagittal planes and three-dimensional rotatory motions around the longitudinal axis with the radioulnar joints. The wrist is vulnerable to axial forces and deforming vectors due to its structure and the large range of motion. Despite this, the wrist remains surprisingly stable even with multidirectional external forces. The wrist maintains the balance between physiological forces and articulations due to intrinsic and extrinsic ligaments. The considerable high loads lead to an imbalance of equilibrium, and instabilities develop.

The extent of ligamentous or osseous lesions determines the degree of carpal instability. The word "dynamic" instability refers to a deformity that only happens while the wrist is in motion, while "static" instability occurs when the wrist is at rest. The main types of instabilities are Radiocarpal and mid-carpal instability. Treatment ranges from wrist braces to ligament reconstruction depending upon the extent of the injury.