If you suffer from severe wrist pain or weakness, please Schedule an appointment with one of our orthopedic specialists as soon as possible.
What is wrist instability?
The wrist is a complex structure which is composed of 15 bones: radius, ulna, scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate and the five metacarpal bones. These bones articulate with each other in more than 20 locations and are surrounded by numerous ligaments which keep the wrist stable throughout its motion. If injury occurs to any of the ligaments, the motion of the wrist is affected and it may become unstable.
What causes wrist instability?
Wrist instability can be caused after injury to ligaments in the wrist occur. Common ligaments that are injured are the scapholunate (SL) ligament, lunotriquetral (LT) ligament. Perilunate injuries and mid carpal instability are also in the bouquet of issues that can cause overall wrist instability. These injuries or tears can happen when a lot of stress is placed on the wrist suddenly, as well as if repeated strain is placed on the wrist over time.
What are the symptoms of wrist instability?
Wrist instability can present with wrist pain, especially during movement of the wrist, and at times with decreased range of motion of the wrist.
Wrist instability is diagnosed with a combination of a clinical examination as well as multiple special Xray views. Unusual gaps between the wrist bones or misalignment of the wrist bones seen on Xray are indicative of ligament injuries. Further imaging with CT scan or MRI to assess the soft tissues may be helpful as well. Wrist arthroscopy can be performed for visualization of the ligaments as well as debridement of torn tissues.
Treatment will be based on many factors including how long the instability has been present and if arthritis has occurred, as well as whether the wrist instability is able to be reduced and what the quality of the tissues are. Treatment may involve wrist support with immobilization using a splint or brace. A steroid injection may help to reduce swelling and pain in order to improve wrist motion. Surgical options include ligament reconstruction as well as wrist bone removal and/or fusion and a wrist denervation procedure. This treatment will be tailored to the individual wrist instability injury and individual patient goals.
AAOS- American Academy of Orthopedic Surgeons wrist arthroscopy OrthoInfo webpage.
ASSH- American Society of Hand Surgery wrist surgery:arthroscopy Handcare webpage.