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Journal of Hand Surgery (European Volume)
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Articles

Arthroscopic Thermal Capsulorrhaphy for Palmar Midcarpal Instability

W. T. M. MASON and D. G. HARGREAVES

From the Trauma and Orthopaedic Directorate, Southampton General Hospital, Southampton, UK

Correspondence: Mr W.T.M Mason, Trauma and Orthopaedic Directorate, F Level, East Wing, Mailpoint 45, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK., Tel.: +44 23 8079 5987; Fax: +44 23 8079 6296. E-mail:willmason{at}doctors.org.uk

Midcarpal instability is an uncommon problem in which deficient static and dynamic wrist stabilisers cause sudden, uncontrolled movement of the proximal carpal row. We studied 15 wrists prospectively in 13 patients who underwent arthroscopic thermal capsulorrhaphy for palmar midcarpal instability. Capsulorrhaphy was performed using standard wrist arthroscopic techniques and a small diameter monopolar radiofrequency probe. One hundred percent follow-up was achieved at a mean of 42 (range 14 – 67) months. With regards to instability, all wrists showed improvement or resolution of instability. Functional improvement was confirmed by an improvement in the mean DASH score from 38 pre-operatively to 17 at final follow-up. Our early results show that thermal capsulorrhaphy is effective in reducing the instability symptoms of palmar midcarpal instability.

Key Words: thermal capsulorrhaphy • capsular shrinkage • midcarpal instability • arthroscopic stabilisation • wrist instability

Journal of Hand Surgery (European Volume), Vol. 32, No. 4, 411-416 (2007)
DOI: 10.1016/J.JHSE.2007.03.012
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