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TOPIC: Wrist Instability/Carpal Instability - Chat:

Wrist Instability/Carpal Instability - Chat: 11 years 11 months ago #1974

Wrist Instability/Carpal Instability (MCI/PMCI) Chat:

Does anyone else suffer from: Midcarpal Instability (Wrist Instability/Carpal Instability), if so tell all the Ablehere users your story & how it effects you with your normal day to day activities & mental health.

If your not sure what: Midcarpal Instability (Wrist Instability/Carpal Instability) is, then go to: www.ablehere.com/component/option,com_jo...iew/id,1162/catid,47

I suffered from suffered from a very Complex & Serious Wrist Disability/Injury while at work on: 13-10-2002 known as: Mid Carpal Instability (MCI)\Palmar Midcarpal Instability (PMCI) in both my left hand & left wrist only which is part of The Repetitive Strain Injury (RSI) Family, & this later lead me to delevlope Moderate-Serve Clinical Depression & Reflex Sympathetic Dystrophy\Complex Regional Pain Syndrome (RSD/CRPS)

Effects of Carpal Instability <br><br>Post edited by: Scott_1984, at: 2009/02/08 09:29

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 11 months ago #1985

Hi There

I am new to this forum and thaught I'd share my experiences with wrist problems.

My wrist problems are fairly new but stems from a much larger problem. I have hyper-mobility in all of my joints. This means that my joints are highly susceptable to inflamation, dislocations and other related problems due to their unnatural range of motion and therefor proned to injury.

For a while now, I have been having problems with painfull inflamation in my left wrist that just does not want to go away, which is strange seeing as I am a software developer and would expect that kind of problem rather in my right hand which handles the mouse. Most of the time my Doc just tells me \"Exercise more\" when it comes to my joints but with my wrist it's different. Your fingers and wrist works on a basis of tendons drawing strength from muscles higher up in your arm. Therefor, there is no direct restraint on the range of motion of the joint.

My Doc's initial treatment was anti-inflamatories...which did butt-kiss. After that I had a voltaren shot in my right and some other painfull shot in my left cheek. The only thing that really seems to work is a bandage around my wrist. So long as I wear the bandage, it's fine. As soon as I remove the bandage the pain returns.

Joint pain, even tho you don't realise it, has a negative impact on your mental state as well. Being Bi-Polar to boot does not help either. Whenever I have an inflamed/dislocated/painfull joint, the frequency and intensity of my manic states seems to decrease notably. Usually they are frequent and very short lived (Which, come to think of it is worst than not having them at all). This leaves me feeling down more intensely and more often.

My doc is more than likely going to suggest surgery if I go to see him again with no improvement. Surgery is THE last thing I want to do. They threatened me with it when I had a serious knee dislocation earlier this year but withdrew it after realising the severity of the situation. Seeing as I have bi-latteral Patella-Alta, surgery would leave me with less than normal mobility instead of more than normal mobility in my knees. Ten to one, the same would be said about wrist surgery.

In trying to find a way to live with the problem I'm wondering...

For my knees, it's most definately out of the question to wear knee gaurds/restraints permenantly as that would worsten the situation by compressing the patella down, which is allready wearing down due to it's incorrect positioning, and causing my leg muscles to grow lasy and not be able to handle the work that my ligaments can't do.

Any suggestions as to wether wearing something like a \"Carpul-tunnel\" restraint, or some such, permenantly is a bad idea?

Cheers for now

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 11 months ago #1992

Hiya Sigma :)

Thanks for your post :)

First are you saying your suffering from Carpal Tunnel Syndrome (CTS) or Midcarpal Instability/Wrist Instability/Carpal Instability, due to your Hypermobility/Hypermobility Syndrome?.

Because if you are saying you have Carpal Tunnel Syndrome (CTS), this could easily be fixed/cured through any 10 minute wrist operation, but it might come back due to your Hypermobility/Hypermobility Syndrome & start pressing against The Carpal Nerve/s again.

But if you are saying you suffer from: Midcarpal Instability/Wrist Instability/Carpal Instability due to your Hypermobility/Hypermobility Syndrome, then this could be harder to treat/diagnosis, as most of your joints would already click, pop, clunk, & dislocate, due to the Hypermobility/Hypermobility Syndrome.

But most treatment for Midcarpal Instability/Wrist Instability/Carpal Instability are still very Controversial.

If you had Midcarpal Instability/Wrist Instability/Carpal Instability, an Doctor/Consultant would suggest hand/wrist physiotherapy exercises, an Palmar Wrist Splint & that should contain a metal plate in the splint, you'd only take this splint off for Twice A Day Phsyiotherapy & Baths/Showers, & Washing Up, you'd also have to wear it at night. (You'd most likely have to wear the wrist splint for life, to do normal day to day activities & typing & so on)

If that didn't work or improve the disability, then they would suggest: an Ligament Tightening Wrist Operation & if that didn't work an full or limited wrist fusion.

Also if you had Midcarpal Instability/Wrist Instability/Carpal Instability, you would at some stage develop: Osteoarthritis.

If you do have: Midcarpal Instability/Wrist Instability/Carpal Instability & you didn't fancy the Ligament Tightening Wrist Operation or the full/limited wrist fusion/s, & Twice A Day Phsyiotherapy & Palmar Wrist Splint, didn't help.

Then you might want to think about this Experimental/Controversial Operation known as: Thermal Capsulorrhaphy for Midcarpal Instability, its been used on Shoulder Instability over the past 10 years & its apparently on Shoulder Instability in the long-term, its also very useful for suffers of loose/lax ligaments within there whole body.

More Information On: Thermal Capsulorrhaphy for Midcarpal Instability Can Be Found At: wristinstability.multiply.com/journal/item/12

But if you where suffering from Carpal Tunnel Syndrome, I'd say the 10 minute surgery to cure/fix it for life or a long period might be best or use an Carpal Tunnel Wrist Brace.<br><br>Post edited by: Scott_1984, at: 2009/02/08 09:30

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 11 months ago #1993

If your not sure what: Midcarpal Instability (Wrist Instability/Carpal Instability) is, then go to: www.ablehere.com/component/option,com_jo...iew/id,1162/catid,47

If your not sure what: Carpal Tunnel Syndrome (CTS) is, then go to: www.ablehere.com/component/option,com_jo...iew/id,1178/catid,47

More Information On: Hypermobility/Hypermobility Syndrome, Can Be Found At: www.ablehere.com/component/option,com_jo...iew/id,1222/catid,47

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 11 months ago #1994

Hiya Again Sigma :)

Sometimes there's a risk to develop: Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome 1&2 (RSD/CRPS 1&2) with the use of: long term Cast or Splint immobilization for a fracture or sprain & the same can be said for any Injuries, Traumas to any limb/body, or operations/surgies.

Copy Of Quote Can Be Found At: Effects of Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome 1&2 (RSD/CRPS 1&2) & wristinstability.multiply.com/journal/item/44 On Page: 16/17 - Risk Factors for Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome 1&2 (RSD/CRPS 1&2) - There are several risk factors for the development of reflex sympathetic dystrophy (RSD) including:

Cast or splint immobilization for a fracture or sprain.

Surgery - RSD has been reported to occur following certain surgical procedures on the
extremities such as carpal tunnel release surgery, knee arthroscopy, hip arthroplasty,
amputation, or ankle arthrodesis
.

Neurological events or conditions - RSD may be seen as part of other neurological diseases
such as carpal tunnel syndrome or pinched spinal nerves
.<br><br>Post edited by: Scott_1984, at: 2009/02/08 09:33

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 11 months ago #2006

Hi :)

Thanks for the response. It initially seemed like Midcarpal Instability/Wrist Instability/Carpal Instability. Pops and clicks are abundoned in my body...I even get them in the middle of my rib-cage at times...that's an odd experience I'll tell ya :P. Initially when the doctor looked at my wrist, he manipulated it a bit and it did pop. ( Howcome every time I see him he does exactly what I don't want him to do :P Like when I dislocate my knee he would yank my leg to see how lax the ligemants is :S )

However, I had some X-Rays done on Saturday after a visit to the Doc and the results are quite confusing. The report stated that there was no abnormalities in the soft tissue and/or bones..ruling out carpal tunnel... and that my carpal index was only a few degrees above the norm which is considered to still be normal...ruling out HMS? Further more, there was no signs of either arthrites or arthrites spurs, which is something my doctor was concerned about initially, before the x-ray results.

When you say...quote...

\"It is essential to note that the unstable wrist initially does not cause relevant signs in standard radiograms, therefore being \"occult\" for the radiologic assessment.\"

Does that mean that it's not identifiable via normal x-rays?

The most frequent and serious dislocations occur in my knees, most likely to the bi-lateral patella-alta. I have had several minor hip and ankle \"misalignment\" which was not serious enough to see the doc for. I tend to get slight ankle problems when I'm walking bare-foot or with shoes that does not have ankle support.

I am beginning to wonder now what the difference is between carpal/joint mobility, which is bone alignment specific, and the flexibility/elasticity of the ligaments/tendons which has to do with the ease that your carpal/joints move within their normal range.

I have also heard that, a \"normal\" person can't scratch/wash their own backs very easily...I have never had any problems with that. So I can't see how HMS could be ruled out.

The doctors frustrate me to no end. None of them are forthcoming with the reasons for my constant joint problems. The one would mumble something about \"Marfans\"...the other \"Long finger syndrome/Arachnoidity\" and others \"Growth spurt\" when I was younger all of which has to do with connective tissue.

My sister has had major surgery on her toes, my father has deteriorating hearing loss due to connective tissue degeneration in his ears, as far as the doctors are concerned and my Grandma passed away from a third stroke last year, all connective tissue related. Therefor the assumption that it could not have to do with \"Growth spurts\".

Thank you for listening...and my appologies for all th e fishing and guessing :blush: as it is dangerous to make assumptions :pinch: But I am really at wits end.

If I don't know what is wrong and if not even the doctors could tell me what's wrong, how do I take care of the problem... :dry: And more importantly...how do I take care of my joints in the future to avoid something like the one specialist wanted to do...\"Permenantly fuse the knee joint to keep the patella in place\"...:angry:

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 10 months ago #2011

Hiya Sigma :)

Thanks for your reply to my last replies.

I'll try to answer or provide more information on some of your other points later.

But I'll answer this question, as I know more about suffering & trying to diagnosing Mid Carpal Instability (Carpal Instability).

When you say...quote...

\"It is essential to note that the unstable wrist initially does not cause relevant signs in standard radiograms, therefore being \"occult\" for the radiologic assessment.\"

Does that mean that it's not identifiable via normal x-rays?.

Soft tissue damage will never show up on plan X-rays & are also often missed on MRI Scans.

The surgeon will most probably choose Wrist Arthroscopy &/Or Physical Examinations/Tests on testing to see if you suffer from Mid Carpal Instability (Carpal Instability) & this will often mean testing/examaning both hands/wrists & bending/moving them to see if they Click, Pop, or Clunk, & to see if they are only in one wrist or both.

Another way to see if you have Mid Carpal Instability (Carpal Instability), without having Wrist Arthroscopy Surgery, is to ask for an detailed VideoFluoroscopy of both your hands/wrists to see if you suffer from Mid Carpal Instability (Carpal Instability).

Most soft tissue injuries/disablities will never show up on plan X-rays & they will only be obvious like in 5 - 10 years time, when the bones/joints have moved totally out of place or normal range.

So in other words soft tissue will never show up on a plan X-rays & its only years later that the hospital might notice there could be a soft tissue injury/disability, as all the bones have moved out of normal range/aliment

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 9 months ago #2108

Wrist Instability/Carpal Instability - Chat:

Another Wrist Instability/Carpal Instability Suffer & Her Story: wristinstability.multiply.com/notes/item/6 & msngroup.aimoo.com/PalmarMidcarpalInstabilityPMCIRSD

From: Michelle (yarnsbaby1) (Original Message) Sent: 12/5/2007 5:32 PM

Hi. My name is Michelle. I am 28 and for Southampton (UK)

I am not sure if this place is still active or not but I just wanted to say I have read your posts regarding midcapsular instability / wrist instability (what ever you chose to call yours) and what confuses me is why hasnt anyone suggested to you capsular shrinkage? I have had severe disabling problems with both my wrists for almost 15 years. In 2001 my Orthopaedic Hand Surgeon perform an experimental piece of surgery on my left wrist whereby he used the techniques similar to those of what is current used in shoulder instability to \"stabilise\" my wrist. It was a HUGE success, he has since been performing this surgery and it is currently very popular in Germany!! Anyway it is still experimental and with my left such a success I had my right wrist treated last tuesday (I am still sewn and bandages up as I type this out!!) My pain has decreased to almost zero, the stability of my wrist is such that I can now make myself a cup of tea without major agony or severe accidents but best of all for me I am also able to perform my own catheterisation which has not been possible for over 5 years.

I wont say much more as I am not sure if this is an active forum but if it is please reply I am happy to talk about my surgery and my wonderful surgeon in more detail.

Best wishes & merry xmas. Michelle :)<br><br>Post edited by: Scott_1984, at: 2009/02/08 09:34

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 9 months ago #2109

Wrist Instability/Carpal Instability - Chat:

Another Wrist Instability/Carpal Instability Suffer & Her Story: wristinstability.multiply.com/notes/item/6 & msngroup.aimoo.com/PalmarMidcarpalInstabilityPMCIRSD

From: Michelle (yarnsbaby1) Sent: 12/11/2007 9:30 AM

I was the first patient David Hargreaves operated on!!! Am in a bit of pain at the moment from Tuesday but as soon as I am stable I promise I will join your other groups and share my full story x x x :)<br><br>Post edited by: Scott_1984, at: 2009/02/08 09:35

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 9 months ago #2110

Wrist Instability/Carpal Instability - Chat:

Another Wrist Instability/Carpal Instability Suffer & Her Story: wristinstability.multiply.com/notes/item/6 & msngroup.aimoo.com/PalmarMidcarpalInstabilityPMCIRSD

From: Michelle (yarnsbaby1) Sent: 1/17/2008 4:26 PM

Hi Scott

So sorry for the delay in replying, I have been in and out of hospital for 3 weeks due to a horrendous urine infection which spread to my kidneys, anyway I am on the road to recovery. I have been trying to join ablehere but everytime I try it keeps telling me my session has timed out and i've no idea what that means!!

Anyway I will try to answer your questions as best as I can.

I have been suffering from recurrent breaks, episodes of giving way, severe pain and swelling in my wrists since 1995, I was led to believe this was due to hypermobile joints until I met Mr David Hargreeves in 1999. I was diagnosed with MCI and in 2000 he suggested I have Thermal Capsulorrhaphy to which he had never performed before!! I was his 1st patient on 1st April 2001 my left wrist was operated on. I had my right wrist done on 27th Nov 2007, it would have been sooner but due to having babies and my other neurological condition there were many delays. The procedures were performed under general anasethic. I woke with my wrist elevated at the elbow and in very padded bandage. The pain was not unbearable but for my left wrist I needed morphine for 24 hours followed by tramadol for 2 days and then codeine and paracetamol for a week. For my right wrist I only needed codeine & paracetamol for 4 days. After 2 weeks I returned for my stitches out and then I was placed in cast for 6 weeks. This I am told is the most important stage of the procedure, for 6 weeks the wrist must be immobile for the best benefits. Both times all pain disappeared within 2 weeks.

After the 6 weeks I started physiotherapy as your wrists are basically temporaily fused. I am still in process of physio for my right which I hasten to add feels amazing, a little stiff but NO pain, movement is still limited due but will be returned to normal I hope once the physio ends. FOr my left wrist It took several months of slow rehabilitation to regain the full usage, although I am not limited in its use in anyway its movement is minorly restricted but this I believe is the whole point of the operation (to stop the instability!!) Almost 7 years down the line and I am pleased to say i'm still pain free, however my wrist is slightly looser but no episodes of instability. I have been told the operation may need to be repeated in 2-3 years to keep the full benefits (so they say it lasts around 10yrs) but this is just a maybe.

I have a neurological condition as a concequence I self-catheterise. Before the op on my right wrist I was unable to do this myself as the pain was unbearable plus when I bent my wrist to the position it used to \"pop out\" and give way. I also struggled to take full control of my personal care (washing my hair, cleaning my teeth etc) due to the pain and giving way. 7 weeks after my left wrist I was able to perfom these tasks myself with just my right wrist limiting me. 8 weeks since my right was operated on and the outlook is good. I am out of cast, having physio and for the first time in 9 years I have been able to catheterise myself. This has been totally liberating as I can now go out alone without the fear of needing to wee!!

Again before the operations simple things such as cooking a meal, shopping, driving, typing on the pc, washing up etc were unbelievably painful and limiting. Now I am able to do everything for myself. I can not think of a single task I have been limited to do, my life feels like it has started over again and I have David Hargreeves to thank for it.<br><br>Post edited by: Scott_1984, at: 2009/02/08 09:36

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 9 months ago #2111

ARTHROSCOPIC CAPSULAR SHRINKAGE FOR MIDCARPAL INSTABILITY OF THE WRIST: proceedings.jbjs.org.uk/cgi/content/abstract/85-B/SUPP_II/177-c

This prospective study evaluated our results of arthroscopic electrothermal capsular shrinkage intrinsic (palmar) for midcarpal instability.

This method of treatment has not been described in the wrist in current literature.

Following clinical and video fluoroscopic diagnosis arthroscopy of the wrist and capsular shrinkage was performed on five patients.

A radiofrequency probe was mainly used on the ulnar arm of the volar arcuate ligament and the dorsal capsule of the radiocarpal joint.

One patient was lost to follow up. At a mean follow up of 11 months the results were: one excellent, two good and one fair using the Green and O’Brien wrist scoring system (Table1).

The average range of motion was 95 percent of the opposite wrist.

We concluded that arthroscopic radiofrequency capsular shrinkage is an effective, minimally invasive method of treatment for intrinsic midcarpal instability.

&

Thermal Capsulorrhaphy for Midcarpal Instability: Meeting/Minutes of meeting held in November 2006 for THE BRITISH SOCIETY FOR SURGERY OF THE HAND (The British Hand Club) AUTUMN MEETING on 02nd & 03rd of November 2006: (Page: 47) (Journal Attached): wristinstability.multiply.com/notes/item/6 & msngroup.aimoo.com/PalmarMidcarpalInstabilityPMCIRSD

Mr W T M Mason, Mr D Hargreaves (Southampton):

Introduction: Midcarpal instability is an uncommon but troublesome problem. For those in whom conservative measures fail, open ligament reconstruction or fusions have been described. We prospectively studied seventeen wrists in fourteen patients who underwent arthroscopic thermal capsulorrhaphy for midcarpal instability.

Methods: All patients were assessed clinically, by fluoroscopy and arthroscopy to confirm the diagnosis. Wrist arthroscopy with four portals was performed and monopolar radiofrequency thermal capsulorrhaphy was performed using a 2.3mm probe.

Results: 100% follow-up was achieved at a a mean of 42 months. Symptoms of instability were resolved completely in four wrists and almost completely in the remaining thirteen. The patients’ subjective overall assessment of the wrist was “much better” in twelve wrists, “better” for two wrists and “worse” for three wrists. These three cases had persistent pain despite the improvement in stability.

The cause of the pain was unrelated to the procedure or the initial pathology.

All patients were satisfied with the outcome and would undergo the same procedure again. Functional improvement was confirmed by an improvement in the mean DASH score from 38.3% pre-operatively to 17.0% at final follow-up. Mean wrist flexion and extension decreased by 25% and 17% respectively. There were no significant complications.

Conclusions: Thermal capsulorrhaphy greatly reduces symptoms of instability in patients with midcarpal instability. Longer follow-up is planned to observe whether these encouraging mid-term results deteriorate over time, as has been witnessed in the shoulder.<br><br>Post edited by: Scott_1984, at: 2009/02/08 09:37

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Re:Wrist Instability/Carpal Instability - Chat: 11 years 7 months ago #2262

Website Asking Questions On Carpal Instability: en.allexperts.com/sitesearch.htm?terms=Wrist+Instability

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