TRIQUETROHAMATE ARTHRODESIS FOR MIDCARPAL INSTABILITY

To assess our results in the management of midcarpal instability with limited wrist arthrodesis, we retrospectively reviewed the records of 10 patients (11 wrists) who had undergone triquetrohamate arthrodesis for symptomatic midcarpal instability. Diagnosis was based on ulnar-si de wrist pain, maximum tenderness over the triquetrohamate joint, and characteristic findings on cineradiographic examination. In nine patie nts, the proximal carpa[ row suddenly snapped into extension as the wr ist was manipulated from radial to ulnar deviation. In one patient (bo th wrists), the distal carpa[ row could be dorsally subluxed by direct pressure and axial compression. Both these maneuvers reproduced the p atients' symptoms. All cases had failed to improve with prior nonopera tive treatment or soft tissue reconstruction. Triquetrohamate arthrode sis was performed to provide midcarpal joint stability. The followup t ime averaged 26 months (range, 6-72). There were two excellent, four g ood, three fair, and two poor results. Compared to the contralateral s ide, range of motion averaged 55% flexion, 69% extension, 61% radial d eviation, and 64% ulnar deviation, and grip strength averaged 64%. The stability provided by triquetrohamate arthrodesis failed to control s ymptoms in almost 50% of cases.