Decoding Carpal Instability: Anatomy, Patterns, and Clinical Strategies

Presented by: Shrikant J. Chinchalkar, MTh.O, B.Sc.OT, OTR, CHT

Webinar Description:

The wrist is a highly intricate functional unit composed of multiple joints formed by the carpal bones, each with a distinctive shape and geometric configuration. These joints are stabilized by an intricate system of ligaments and regulated by musculotendinous units. Achieving the proper balance of carpal stability and movement is crucial for maintaining normal hand function, which enables effective grasping and object manipulation in various wrist positions.

Carpal dislocations and instabilities are relatively common, particularly among young adults, and are most frequently the result of traumatic injuries. However, factors such as congenital ligamentous laxity, infection, inflammatory conditions (e.g., rheumatoid arthritis), and congenital anomalies can also contribute to these disruptions. Carpal instability patterns are often challenging to diagnose accurately, increasing the risk of misdiagnosis or delayed treatment. Without prompt and appropriate management, these injuries can lead to altered carpal kinematics, ultimately resulting in premature degenerative changes and arthrosis at the radiocarpal and midcarpal joints.

This webinar will provide an in-depth review of wrist and carpal anatomy cadaverically, the biomechanics underpinning normal and pathological motion, and the various patterns of carpal instability. Additionally, it will outline principles for clinical assessment and management strategies to optimize patient outcomes.

Learning Objectives:

By the end of this course, participants will be able to:

• Identify the anatomical structures of the wrist and carpus, including key articulations, ligaments, and musculotendinous units.
• Explain the biomechanical principles governing normal wrist function and the impact of carpal instability on hand mechanics.
• Recognize common patterns and mechanisms of carpal dislocations and instabilities, including both traumatic and non-traumatic etiologies.
• Differentiate between clinical presentations of carpal instability and describe the diagnostic challenges associated with these injuries.
• Outline evidence-informed management strategies for carpal instability, including indications for conservative and surgical interventions.

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