First identified by Lichtman in 1980. Patients often present volar sag on the ulnar side of the wrist and give a history of painful “Clunk”. This is caused by laxity of proximal & midcarpal ligaments. Upon testing forearm pronation an obvious clunk is seen. During radio-ulnar motion – the palmar sag disappears with a catch-up clunk. Interestingly, a painful clunk is present while testing the wrist in pronation as compared to testing insupination.

Video Gallery

Clunk in Pronation

No Clunk in Supination

Midcarpal-Instability

Midcarpal Instability-1

Midcarpal Instability-quicktime