Wrist Instability/Carpal Instability - Chat:

Hiya Sigma

Thanks for your reply to my last replies.

I'll try to answer or provide more information on some of your other points later.

But I'll answer this question, as I know more about suffering & trying to diagnosing Mid Carpal Instability (Carpal Instability).

When you say...quote...

\"It is essential to note that the unstable wrist initially does not cause relevant signs in standard radiograms, therefore being \"occult\" for the radiologic assessment.\"

Does that mean that it's not identifiable via normal x-rays?.

Soft tissue damage will never show up on plan X-rays & are also often missed on MRI Scans.

The surgeon will most probably choose Wrist Arthroscopy &/Or Physical Examinations/Tests on testing to see if you suffer from Mid Carpal Instability (Carpal Instability) & this will often mean testing/examaning both hands/wrists & bending/moving them to see if they Click, Pop, or Clunk, & to see if they are only in one wrist or both.

Another way to see if you have Mid Carpal Instability (Carpal Instability), without having Wrist Arthroscopy Surgery, is to ask for an detailed VideoFluoroscopy of both your hands/wrists to see if you suffer from Mid Carpal Instability (Carpal Instability).

Most soft tissue injuries/disablities will never show up on plan X-rays & they will only be obvious like in 5 - 10 years time, when the bones/joints have moved totally out of place or normal range.

So in other words soft tissue will never show up on a plan X-rays & its only years later that the hospital might notice there could be a soft tissue injury/disability, as all the bones have moved out of normal range/aliment

Wrist Instability/Carpal Instability - Chat:

Another Wrist Instability/Carpal Instability Suffer & Her Story: wristinstability.multiply.com/notes/item/6 & msngroup.aimoo.com/PalmarMidcarpalInstabilityPMCIRSD

From: Michelle (yarnsbaby1) (Original Message) Sent: 12/5/2007 5:32 PM

Hi. My name is Michelle. I am 28 and for Southampton (UK)

I am not sure if this place is still active or not but I just wanted to say I have read your posts regarding midcapsular instability / wrist instability (what ever you chose to call yours) and what confuses me is why hasnt anyone suggested to you capsular shrinkage? I have had severe disabling problems with both my wrists for almost 15 years. In 2001 my Orthopaedic Hand Surgeon perform an experimental piece of surgery on my left wrist whereby he used the techniques similar to those of what is current used in shoulder instability to \"stabilise\" my wrist. It was a HUGE success, he has since been performing this surgery and it is currently very popular in Germany!! Anyway it is still experimental and with my left such a success I had my right wrist treated last tuesday (I am still sewn and bandages up as I type this out!!) My pain has decreased to almost zero, the stability of my wrist is such that I can now make myself a cup of tea without major agony or severe accidents but best of all for me I am also able to perform my own catheterisation which has not been possible for over 5 years.

I wont say much more as I am not sure if this is an active forum but if it is please reply I am happy to talk about my surgery and my wonderful surgeon in more detail.

Best wishes &amp; merry xmas. Michelle <br><br>Post edited by: Scott_1984, at: 2009/02/08 09:34

Wrist Instability/Carpal Instability - Chat:

Another Wrist Instability/Carpal Instability Suffer &amp; Her Story: wristinstability.multiply.com/notes/item/6 & msngroup.aimoo.com/PalmarMidcarpalInstabilityPMCIRSD

From: Michelle (yarnsbaby1) Sent: 12/11/2007 9:30 AM

I was the first patient David Hargreaves operated on!!! Am in a bit of pain at the moment from Tuesday but as soon as I am stable I promise I will join your other groups and share my full story x x x <br><br>Post edited by: Scott_1984, at: 2009/02/08 09:35

Wrist Instability/Carpal Instability - Chat:

Another Wrist Instability/Carpal Instability Suffer &amp; Her Story: wristinstability.multiply.com/notes/item/6 & msngroup.aimoo.com/PalmarMidcarpalInstabilityPMCIRSD

From: Michelle (yarnsbaby1) Sent: 1/17/2008 4:26 PM

Hi Scott

So sorry for the delay in replying, I have been in and out of hospital for 3 weeks due to a horrendous urine infection which spread to my kidneys, anyway I am on the road to recovery. I have been trying to join ablehere but everytime I try it keeps telling me my session has timed out and i've no idea what that means!!

Anyway I will try to answer your questions as best as I can.

I have been suffering from recurrent breaks, episodes of giving way, severe pain and swelling in my wrists since 1995, I was led to believe this was due to hypermobile joints until I met Mr David Hargreeves in 1999. I was diagnosed with MCI and in 2000 he suggested I have Thermal Capsulorrhaphy to which he had never performed before!! I was his 1st patient on 1st April 2001 my left wrist was operated on. I had my right wrist done on 27th Nov 2007, it would have been sooner but due to having babies and my other neurological condition there were many delays. The procedures were performed under general anasethic. I woke with my wrist elevated at the elbow and in very padded bandage. The pain was not unbearable but for my left wrist I needed morphine for 24 hours followed by tramadol for 2 days and then codeine and paracetamol for a week. For my right wrist I only needed codeine &amp; paracetamol for 4 days. After 2 weeks I returned for my stitches out and then I was placed in cast for 6 weeks. This I am told is the most important stage of the procedure, for 6 weeks the wrist must be immobile for the best benefits. Both times all pain disappeared within 2 weeks.

After the 6 weeks I started physiotherapy as your wrists are basically temporaily fused. I am still in process of physio for my right which I hasten to add feels amazing, a little stiff but NO pain, movement is still limited due but will be returned to normal I hope once the physio ends. FOr my left wrist It took several months of slow rehabilitation to regain the full usage, although I am not limited in its use in anyway its movement is minorly restricted but this I believe is the whole point of the operation (to stop the instability!!) Almost 7 years down the line and I am pleased to say i'm still pain free, however my wrist is slightly looser but no episodes of instability. I have been told the operation may need to be repeated in 2-3 years to keep the full benefits (so they say it lasts around 10yrs) but this is just a maybe.

I have a neurological condition as a concequence I self-catheterise. Before the op on my right wrist I was unable to do this myself as the pain was unbearable plus when I bent my wrist to the position it used to \&quot;pop out\&quot; and give way. I also struggled to take full control of my personal care (washing my hair, cleaning my teeth etc) due to the pain and giving way. 7 weeks after my left wrist I was able to perfom these tasks myself with just my right wrist limiting me. 8 weeks since my right was operated on and the outlook is good. I am out of cast, having physio and for the first time in 9 years I have been able to catheterise myself. This has been totally liberating as I can now go out alone without the fear of needing to wee!!

Again before the operations simple things such as cooking a meal, shopping, driving, typing on the pc, washing up etc were unbelievably painful and limiting. Now I am able to do everything for myself. I can not think of a single task I have been limited to do, my life feels like it has started over again and I have David Hargreeves to thank for it.<br><br>Post edited by: Scott_1984, at: 2009/02/08 09:36

ARTHROSCOPIC CAPSULAR SHRINKAGE FOR MIDCARPAL INSTABILITY OF THE WRIST: proceedings.jbjs.org.uk/cgi/content/abstract/85-B/SUPP_II/177-c

This prospective study evaluated our results of arthroscopic electrothermal capsular shrinkage intrinsic (palmar) for midcarpal instability.

This method of treatment has not been described in the wrist in current literature.

Following clinical and video fluoroscopic diagnosis arthroscopy of the wrist and capsular shrinkage was performed on five patients.

A radiofrequency probe was mainly used on the ulnar arm of the volar arcuate ligament and the dorsal capsule of the radiocarpal joint.

One patient was lost to follow up. At a mean follow up of 11 months the results were: one excellent, two good and one fair using the Green and O’Brien wrist scoring system (Table1).

The average range of motion was 95 percent of the opposite wrist.

We concluded that arthroscopic radiofrequency capsular shrinkage is an effective, minimally invasive method of treatment for intrinsic midcarpal instability.

&amp;

Thermal Capsulorrhaphy for Midcarpal Instability: Meeting/Minutes of meeting held in November 2006 for THE BRITISH SOCIETY FOR SURGERY OF THE HAND (The British Hand Club) AUTUMN MEETING on 02nd &amp; 03rd of November 2006: (Page: 47) (Journal Attached): wristinstability.multiply.com/notes/item/6 & msngroup.aimoo.com/PalmarMidcarpalInstabilityPMCIRSD

Mr W T M Mason, Mr D Hargreaves (Southampton):

Introduction: Midcarpal instability is an uncommon but troublesome problem. For those in whom conservative measures fail, open ligament reconstruction or fusions have been described. We prospectively studied seventeen wrists in fourteen patients who underwent arthroscopic thermal capsulorrhaphy for midcarpal instability.

Methods: All patients were assessed clinically, by fluoroscopy and arthroscopy to confirm the diagnosis. Wrist arthroscopy with four portals was performed and monopolar radiofrequency thermal capsulorrhaphy was performed using a 2.3mm probe.

Results: 100% follow-up was achieved at a a mean of 42 months. Symptoms of instability were resolved completely in four wrists and almost completely in the remaining thirteen. The patients’ subjective overall assessment of the wrist was “much better” in twelve wrists, “better” for two wrists and “worse” for three wrists. These three cases had persistent pain despite the improvement in stability.

The cause of the pain was unrelated to the procedure or the initial pathology.

All patients were satisfied with the outcome and would undergo the same procedure again. Functional improvement was confirmed by an improvement in the mean DASH score from 38.3% pre-operatively to 17.0% at final follow-up. Mean wrist flexion and extension decreased by 25% and 17% respectively. There were no significant complications.

Conclusions: Thermal capsulorrhaphy greatly reduces symptoms of instability in patients with midcarpal instability. Longer follow-up is planned to observe whether these encouraging mid-term results deteriorate over time, as has been witnessed in the shoulder.<br><br>Post edited by: Scott_1984, at: 2009/02/08 09:37

Website Asking Questions On Carpal Instability: en.allexperts.com/sitesearch.htm?terms=Wrist+Instability