The Unstable Capitolunate and Radiolunate Joints as a Source of Wrist Pain in Young Women

Abstract

A retrospective study of 12 young women (14 cases) complaining of chronic wrist pain, obscure numbness and reduction of grip strength is presented. The average duration of the complaints was 7.3 years. All wrists were in VISI alignment, with normal motion series and normal intrinsic interosseous ligaments demonstrated arthrographically. The dorsal-displacement stress test showed subluxation of the capitolunate (in nine cases) or both the capitolunate and the radiolunate joints accompanied by a marked feeling of apprehension. Surgical management consisted of ligamentous reefing of the whole palmar aspect of the midcarpal joint and the radiolunate joint when needed. Additionally, a neurectomy of the terminal branch of the anterior interosseous nerve was done in four cases. The result was excellent in eight cases, good in five cases and fair in 1 case. Young women with “delicate” wrists and obscure wrist pain may have isolated instabilities of the capitolunate and radiolunate joints. In cases that do not respond to conservative measures ligamentous reefing should be considered.