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midcarpal subluxation

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In a karate tournament, i injured my hand/wrist while punching. After x rays and examination, Doctor diagnosed torn or damaged ligaments at the carpal level. It has been now 3 months and i still have instability in the wrist and pain. My wrist will clunk and click from time to time. My questions are the following: 1. Can an instability in the wrist go away with time? or is surgery always needed. 2. How long does it take for arthritis to settle in. BTW, i am 33 years old, perfect health.

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  2. R. Schmitt1 , S. Froehner1, G. Coblenz1 and G. Christopoulos1(1) Herz- und Gefklinik GmbH, Institut fr Diagnostische und Interventionelle Radiologie, Salzburger Leite 1, 97616 Bad Neustadt an der Saale, Germany Received Abstract This review addresses the pathoanatomical basics as well as the clinical and radiological presentation of instability patterns of the wrist. Carpal instability mostly follows an injury; however, other diseases, like CPPD arthropathy, can be associated. Instability occurs either if the carpus is unable to sustain physiologic loads (dyskinetics) or suffers from abnormal motion of its bones during movement (dyskinematics). In the classification of carpal instability, dissociative subcategories (located within proximal carpal row) are differentiated from non-dissociative subcategories (present between the carpal rows) and combined patterns. It is essential to note that the unstable wrist initially does not cause relevant signs in standard radiograms, therefore being occult for the radiologic assessment. This paper emphasizes the high utility of kinematographic studies, contrast-enhanced magnetic resonance imaging (MRI) and MR arthrography for detecting these predynamic and dynamic instability stages. Later in the natural history of carpal instability, static malalignment of the wrist and osteoarthritis will develop, both being associated with significant morbidity and disability. To prevent individual and socio-economic implications, the handsurgeon or orthopedist, as well as the radiologist, is challenged for early and precise diagnosis.Keywords Dysfunction – Wrist – Magnetic resonance imaging – Kinematography – Instability

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