Carpal instability refers to abnormal movement of the small bones in the wrist joint, which can cause pain, weakness, and reduced function. The wrist joint is made up of eight small bones called carpals, which are held together by ligaments and other soft tissues.
There are several types of carpal instability, including:
Dorsal instability: This occurs when the bones in the back of the wrist move out of alignment.
Volar instability: This occurs when the bones in the front of the wrist move out of alignment.
Ulnar-sided instability: This occurs when the bones on the pinky finger side of the wrist move out of alignment.
Radial-sided instability: This occurs when the bones on the thumb side of the wrist move out of alignment.
This can be caused by a variety of factors, including trauma, degenerative changes, and congenital disorders. Some of the causes of carpal bone instability are:
Trauma: The most common cause of wrist instability is a wrist injury such as a wrist crush.
A sprain, fracture or dislocation. Trauma can damage the ligaments that hold the carpal bones in place, making them unstable.Degenerative changes: Over time, the cartilage in your wrist can wear away, leading to arthritis.This can cause your carpal bones to shift and become unstable.
Congenital disorders: Some people are born with disorders that affect the development of the bones and ligaments of the wrist. These include conditions such as Madelung deformity and congenital radioulnar synostosis, which can lead to carpal instability.
Connective tissue disorders: Disorders such as Ehlers-Danlos syndrome and Marfan syndrome affect the strength and stability of the wrist ligaments and can lead to carpal instability.
Treatment options for carpal instability depend on the severity of the condition, the underlying cause, and the patient's individual needs and goals. Here are some common treatment options:
Immobilization: In mild cases, immobilization of the wrist with a splint or brace may be recommended to allow the ligaments and bones to heal.Physical therapy: Physical therapy can help improve wrist strength, flexibility, range of motion, and reduce pain and swelling.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce pain and inflammation.
Injections: Corticosteroid injections can be used to reduce inflammation and relieve wrist pain.
Surgery: In severe cases, surgery may be required to stabilize the wrist. Surgery may involve ligament repair or reconstruction, or bone fusion.