We need you! See something you could improve? Make an edit and help improve WikSM for everyone.
Lunotriquetral Instability
From WikiSM
Contents
Other Names
- Lunotriquetral Ligament Injury
- Volar Intercalated Segment Instability
- VISI
Background
- Involves injury to the Lunotriquetral Ligament, which secures the relationship between the Lunate and Triquetral
- Radiotriquetral Ligament may also be injured
- Occurs much less commonly than scapholunate ligament injuries
Pathophysiology
- Traumatic injury with wrist in hyperextension or extension and radial deviation
Risk Factors
- Unknown
Differential Diagnosis
- Fractures
- Dislocations
- Wrist Dislocation (Radiocarpal and/or Ulnocarpal)
- Carpometacarpal Joint Dislocation
- Distal Radioulnar Joint Dislocation
- Lunate Dislocation
- Perilunate Dislocation
- Instability & Degenerative
- Tendinopathies & Ligaments
- Neuropathies
- Pediatric Considerations
- Distal Radial Epiphysitis (Gymnast's Wrist)
- Torus Fracture
- Arthropathies
- Cartilage
- Vascular
- Other
Clinical Features
- History
- Needs to be updated
- Physical Exam: Physical Exam Wrist
- Pain, swelling, carpal tenderness
- Special Tests
- Kleinmans Shear Test: shearing force across LT joint
- Reagans Test: Applying opposing forces to lunate and triquetrum
Evaluation
Radiographs
- Standard Radiographs Wrist
- May be normal on initial evaluation
- Lateral view: Scapholunate angle < 30°, VISI deformity
- AP: break in Gilulas Lines or the carpal alignment
Arthroscopy
- May be required if suspicion is high as radiographs can be normal
Classification
- N/A
Management
Nonoperative
- Indicated at discretion of hand surgeon
Operative
- Indications
- Acute instability
- Chronic instability
Return to Play
- At discretion of surgeon
Complications
- Volar intercalated segmental instability (VISI)
See Also
- Internal
- External
- Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist/
References
Created by:
John Kiel on 18 June 2019 23:14:08
Authors:
Last edited:
13 October 2022 21:48:52
Categories: