Although midcarpal instability was first described almost 45 years ago, this uncommon
condition is still poorly understood by most clinicians today. Adding to the confusion,
it is known by 2 different names: midcarpal instability and carpal instability nondissociative.
In this article, we describe the history of the recognition of instability of the
midcarpal joint, including its pathomechanics, classification, and treatment. We hope
that a more complete understanding of the etymology and kinematics of the disorder
will facilitate its future recognition and assist in appropriate treatment decision
making.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Poignet a’ressaut: subluxation mediocarpienne en avant.Bull Mem Soc Nat Chir. 1934; 60: 1243-1244
- Ulnar midcarpal instability— clinical and laboratory analysis.J Hand Surg. 1981; 6: 515-523
- Midcarpal instability caused by malunited fractures of the distal radius.J Hand Surg Am. 1984; 9: 350-357
- Compensatory carpal malalignments.Ann Chir Main. 1984; 3: 357-363
- Capitate-lunate instability: recognition by manipulation under fluoroscopy.AJR Am J Roentgenol. 1984; 143: 361-364
- Chronic capitolunate instability.J Bone Joint Surg Am. 1986; 68: 1164-1176
- Chronic capitolunate instability.J Bone Joint Surg Am. 1987; 69: 950-951
- Palmar midcarpal instability: results of surgical reconstruction.J Hand Surg Am. 1993; 18: 307-315
- Carpal instability non-dissociative.J Hand Surg Br. 1994; 19: 763-773
- Carpal instability nondissociative.J Am Acad Orthop Surg. 2012; 20: 575-585
- Midcarpal instability: unlocking the secrets of the wrist.Tex Orthop J. 2016; 2: 61-69
- Quantitative assessment of the midcarpal shift test.J Hand Surg Am. 1999; 24: 977-983
- In vivo three-dimensional kinematics of the midcarpal joint of the wrist.J Bone Joint Surg Am. 2006; 88: 611-621
- Biomechanical analysis of palmar midcarpal instability and treatment by partial wrist arthrodesis.J Hand Surg Am. 2018; 43: 331-338.e2
- A preliminary model of the wrist midcarpal joint.J Wrist Surg. 2021; 10: 523-527
- Musculoskeletal modeling of the wrist via a multi body simulation.Life (Basel). 2022; 12: 581
- Unifying model of carpal mechanics based on computationally derived isometric constraints and rules-based motion – the stable central column theory.J Hand Surg Eur. 2014; 39: 353-363
- Development and validation of a computational model for investigation of wrist biomechanics.Ann Biomed Eng. 2011; 39: 2807-2815
- Midcarpal instability: A comprehensive review and update.Hand Clin. 2015; 31: 487-493
- Palmar capsuloligamentous plication in dorsal capitolunate instability: technique and preliminary results.Tech Hand Up Extrem Surg. 2019; 23: 22-26
- Posttraumatic carpal instability nondissociative.J Wrist Surg. 2021; 10: 290-295
- Surgical technique: hemi-extensor carpi radialis brevis tenodesis for stabilizing the midcarpal joint in Ehlers-Danlos syndrome.J Hand Surg Am. 2014; 39: 2071-2074
- Carpal instability in the weight-bearing upper extremity.J Bone Joint Surg Am. 1996; 78: 1838-1843
- Carpal instability nondissociative following acute wrist fractures.J Hand Surg Am. 2020; 45: 662.e1-662.e10
- Traumatic nondissociative carpal instability: a case series.J Hand Surg Am. 2022; 47: 285.e1-285.e11
- Understanding midcarpal instability.J Hand Surg Am. 2006; 31: 491-498
- Introduction to the carpal instabilities.in: Lichtman D.M. The Wrist and its Disorders. Saunders, 1988: 244-250
- Midcarpal instability: the role of wrist arthroscopy.Hand Clin. 2017; 33: 717-726
- Arthroscopic thermal capsular shrinkage for palmar midcarpal instability.J Wrist Surg. 2014; 3: 162-165
- Arthroscopic thermal capsulorrhaphy for palmar midcarpal instability.J Hand Surg Eur. 2007; 32: 411-416
- Palmar midcarpal instability.in: McGinty E. Operative Arthroscopy. 3rd ed. Williams and Wilkins, 2003: 737-742
- Dorsal wrist plication for midcarpal instability.J Hand Surg Am. 2018; 43: 354-359
- Palmar midcarpal instability: the results of treatment with 4-corner arthrodesis.J Hand Surg Am. 2004; 29: 258-263
- Midcarpal instability: is capitolunate instability pattern a clinical condition?.J Hand Surg Br. 1996; 21: 197-201
- The unstable capitolunate and radiolunate joints as a source of wrist pain in young women.J Hand Surg Br. 1996; 21: 501-506
- The non-dissociative clunking wrist: a personal view.J Hand Surg Eur. 2008; 33: 698-711
Article info
Publication history
Published online: November 03, 2022
Accepted:
September 27,
2022
Received:
August 31,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand.