General Carpal Instability
the two most important motions of the wrist
What are ulnar deviation and wrist extension?
The carpal row that has more stability
What is the distal carpal row?
The joint that the TFCC is a major stabilizer for.
What is the DRUJ (distal radial ulnar joint)?
This procedure results in no wrist extension/flexion or ulnar/radial deviation.
What is total wrist arthrodesis?
The procedure with the best preserved motion and grip with stable outcomes and lower revision rates vs four corner arthrodesis that is appropriate for moderate-demand patients?
What is a Proximal Row Carpectomy?
The four bones that make up the proximal carpal row
What are the scaphoid, lunate, triquetrum, and pisiform?
Instability between carpal bones within the proximal row
What is CID (Carpal Instability Dissociative)?
The direction of wrist deviation that commonly increases pain with a TFCC injury.
What is ulnar deviation?
This wrist salvage procedure dictates you never stretch the extrinsic muscles.
What is proximal row carpectomy?
This wrist salvage procedure that eliminates all wrist motion but preserves strong grip and is preferred for heavy demand workers.
What is the lunate?
The most common form of wrist instability where the lunate extends dorsally.
What is DISI (Dorsal Intercalated Segment Instability)
The type of carpal bone dissociation the Derby Maneuver checks for.
What is Lunotriquetral dissociation?
The typical amount of time before a patient can return to heavy labor following a proximal row carpectomy?
What is 4-6 months?
This wrist salvage procedure maintains function motion with varied implant longevity rates and is best for older, low-demand patients?
What is a total wrist arthroplasty?
This motion of the wrist is a combination of all wrist ROM planes
Motion that moves the hand from extension/radial deviation to palmar flexion/ulnar deviation.
What is Dart-Thrower's motion?
Three of the five major components of the TFCC.
1) articular disc
2) dorsal/volar radioulnar ligaments
3) meniscus homologue
4) extensor carpi ulnaris
5) ulnocarpal ligaments
This procedure is commonly used to treat a scapholunate advanced collapse (SLAC) wrist.
This wrist salvage procedure preserves less motion than the PRC with increased stiffness and higher hardware complications and non-union risks.
What is a four-corner fusion?
The direction the scaphoid moves with wrist flexion.
What is volar?
Two of the four common wrist instability patterns.
What are
1) CID: carpal instability dissociative
2) CIND: carpal instability non-dissociative
3) DISI: dorsal intercalated segment instability
4) VISI: volar intercalated segment instability
Three of the wrist salvage procedures when a patient has arthritis of the DRUJ?
This wrist salvage procedure results in the most motion restricted and is best for isolated radoiocarpal pathologies while preserving the lease amount of carpal motion.
What is a radioscapholunate fusion?