Lichtman D M, Schneider J R, Swafford A R, Mack G R
J Hand Surg Am. 1981 Sep;6(5):515-23. doi: 10.1016/s0363-5023(81)80115-3.
Patients with ulnar midcarpal instability have a characteristic pattern of clinical signs and symptoms related to the midcarpal joint. The usual presenting complaint is a painful wrist click which can be reproduced by ulnar deviation, axial compression, and pronation of the wrist. Routine x-rays are usually normal, but cinefluoroscopy reveals sudden dissociation between the proximal and distal carpal rows resulting in a dorsiflexion collapse deformity. In six of our patients, conservative therapy sufficed to relieve symptoms. Four other patients required surgical stabilization. We close to stabilize the triquetrohamate joint because it was a relatively easy procedure and eliminated instability in most instances. Laboratory studies aided in understanding the pathomechanics of midcarpal instability, which consisted of dorsal subluxation of the capitate and hamate on the lunate and triquetrum. We believe that midcarpal instability is not a rare condition but may often be confused clinically with more common carpal dissociations.
尺侧腕中关节不稳的患者具有与腕中关节相关的特征性临床体征和症状模式。常见的主诉是腕部疼痛性弹响，可通过腕部尺偏、轴向挤压和旋前动作诱发。常规X线检查通常正常，但动态荧光透视显示腕骨近排和远排之间突然分离，导致背屈塌陷畸形。在我们的6例患者中，保守治疗足以缓解症状。另外4例患者需要手术稳定。我们选择稳定三角骨钩骨间关节，因为这是一个相对简单的手术，并且在大多数情况下可消除不稳。实验室研究有助于理解腕中关节不稳的病理力学，其表现为头状骨和钩骨在月骨和三角骨上的背侧半脱位。我们认为腕中关节不稳并非罕见疾病，但在临床上常易与更常见的腕骨分离相混淆。
