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through the gap between the carpal bones (‘drive-through phenomena’). Total injury => open re-insertion or ligament reconstruction RC, radiocarpal joint; MC, mid-carpal joint Carpal instability and symptoms Carpal instability

collateral ligament is resutured to the intact phalango-glenoidal component. The retinacular ligament is sutured to the lateral band in order to complete the anatomical reconstruction of the extensor apparatus ( Figs 1 to 4 ). 7 Fig. 1 Proximal

implant arthroplasty, even with formal collateral ligament reconstruction and prolonged splinting during rehabilitation ( Fig. 2 ). Arthrodesis should therefore be considered carefully, especially in the radial digits, if the lateral deformation of the PIP

conclusive evidence ( 1 ). Trapeziectomy, often combined with some sort of ligament reconstruction and tendon interposition is globally most often recommended to patients. The goal of these popular resection arthroplasty procedures is to create a sufficiently

, evident that GPA measured on 3D reconstruction CT scans is the most accurate and reproducible method to assess these fractures. 33 Fig. 3 a) The gleno polar angle (GPA) is normally > 40°, b) GPA is reduced to < 20° due to medialisation and

new devices has, however, changed the outcomes, which are now comparable with published results of ligament reconstruction or ligamentoplasty. 21 , 50 c)  Midcarpal instability is less of a common occurrence. It tends to occur in young

seven hand surgery departments at university hospitals in Sweden, performing all kinds of hand surgery including that relating to acute hand trauma – such as microsurgical reconstructions and joint, tendon, ligament and nerve reconstructions – as well as

, 15 and they may have an effect on treatment decisions. 15 – 17 If injury of the carpal ligaments is suspected, CT or high-resolution magnetic resonance imaging may be beneficial before a final treatment decision is made. 18 , 19 Several

dorsal extrinsic ligament did not cause any clinical or radiological instability. 25 The simple dissection and graft harvesting is the main advantage of this technique. The location of this graft provides easy access to both lunate and the proximal

optimal visualization are prerequisites to success. That way, tissue manipulation can be minimized, neurovascular damage avoided and skin reconstruction successful. Visual enhancement To optimize the visualization of the operating field, loupe