Posttraumatic Carpal Instability Nondissociative.

Urbanschitz, Lukas; Pastor, Tatjana; Fritz, Benjamin; Schweizer, Andreas; Reissner, Lisa (2021). Posttraumatic Carpal Instability Nondissociative. Journal of wrist surgery, 10(4), pp. 290-295. Thieme 10.1055/s-0041-1723794

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Background  Posttraumatic midcarpal instability nondissociative (CIND) is an exceptional rare condition, therefore the outcome after different treatment options remains unknown. Questions  The purpose of this study was to investigate the different treatment options for posttraumatic CIND. We also describe the different radiological and magnetic resonance imaging (MRI) findings in this patient cohort. Patients and Methods  We present outcomes of 10 patients who developed CIND following acute wrist trauma between 2007 and 2018, 3 with dorsal intercalated segment instability pattern (CIND-DISI) and 7 with volar intercalated segment instability (CIND-VISI) radiographically. Results  Three patients with CIND-VISI had satisfactory outcomes with conservative treatment. Two patients with irreducible CIND-DISI and one with CIND-VISI underwent proximal row carpectomy (PRC), two with reducible CIND-VISI had radiolunate fusion, and two with secondary osteoarthritis had total wrist fusion. All patients with CIND-DISI needed surgery, whereas only four of the seven patients with CIND-VISI needed surgery. On MRI, all three patients with CIND-DISI had rupture of the radiolunate ligament. Conclusions  The data collected in this study may provide the first step toward better understanding of the pathology for this exceptionally rare finding. In CIND-VISI, we have not seen any ligament injury in four patients. Therefore, conservative therapy is more likely to be the first step. In CIND-DISI, we recommend an operative procedure: if detected early, with ligament suture, otherwise by radiolunate fusion, PRC, or total wrist fusion. Level of Evidence  This is a Level IV study.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery 04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery
UniBE Contributor:	Pastor, Tatjana
Subjects:	600 Technology > 610 Medicine & health
ISSN:	2163-3916
Publisher:	Thieme
Language:	English
Submitter:	Veronika Picha
Date Deposited:	04 Jan 2022 10:19
Last Modified:	05 Dec 2022 15:56
Publisher DOI:	10.1055/s-0041-1723794
PubMed ID:	34381631
Uncontrolled Keywords:	CIND carpal instability nondissociative carpal malalignment intercalated segment instability ligament lesions
URI:	https://boris.unibe.ch/id/eprint/162354