Jing Shan Shan, Smith Gemma, Deshmukh Subodh
Royal Orthopaedic Hospital, The Woodlands, Bristol Road South, Birmingham, United Kingdom.
J Wrist Surg. 2021 Apr;10(2):94-101. doi: 10.1055/s-0040-1714688. Epub 2020 Aug 27.
Palmar midcarpal instability is an uncommon condition diagnosed clinically with a painful pathognomonic clunk on terminal ulnar deviation of the wrist. Various causes have been described, but congenital laxity of the carpal ligaments is thought to be a key contributor. Treatment commences with conservative measures. This includes proprioceptive training based on more recent concepts on the sensorimotor function of the wrist. When these measures plateau, surgery is considered. The lack of high-level evidence and consensus on its cause continue to hamper our understanding and knowledge of this condition. The purpose of this review is to examine the current evidence to conceptualize this mysterious, yet infrequent phenomenon, and to provide an algorithm on its management.
掌侧腕中关节不稳定是一种临床诊断不常见的病症，在腕关节尺侧终末偏斜时会出现疼痛性特征性弹响。已描述了多种病因，但腕关节韧带先天性松弛被认为是一个关键因素。治疗从保守措施开始。这包括基于腕关节感觉运动功能最新概念的本体感觉训练。当这些措施效果不再进展时，考虑手术治疗。关于其病因缺乏高级别证据和共识，这继续妨碍我们对这种病症的理解和认识。本综述的目的是审视当前证据，以将这种神秘但不常见的现象概念化，并提供其管理的算法。
