MIDCARPAL INSTABILITY - IS CAPITOLUNATE INSTABILITY PATTERN A CLINICAL CONDITION

Five cases are presented with clinical findings of capito-lunate insta bility pattern of the wrist. All painful areas and tender points were dorsal, but variable in location and intensity. All plain radiographs and fluoroscopic instability series were normal. None of the cases had an explanation for the dorsal wrist pain other than a positive dorsal capitate-displacement test. Four out of five cases were treated in a cast for 4 weeks and two had subsequent splint immobilization. Althoug h at short-term follow-up two of these five patients became pain-free, none was completely pain-free at long-term follow-up. Three patients treated with a cast had long-term follow-up. Only one could perform hi s original work, These findings support a clinical condition of midcar pal instability producing dorsal wrist pain reproduced with a simple s tress test. Conservative, non-operative treatment will not usually pro duce long-term pain relief.