Wrist Instability/Carpal Instability - Chat:

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

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

Wrist Instability/Carpal Instability - Chat:

Another Wrist Instability/Carpal Instability Suffer &amp; 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

Wrist Instability/Carpal Instability - Chat:

Another Wrist Instability/Carpal Instability Suffer &amp; 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 &amp; 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 \&quot;pop out\&quot; 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

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.

&amp;

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 &amp; 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

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

Hi there, ive just registered on this site and my problem is this...

In June 2007 i punched a punching bag which i injured myself by a bad technique.I thought i just sprained my hand and didn't dop anything about it, once the swelling went down my wrist still wasn't right. My carpal on the top of my hand keeps popping up and out when i clench my fist and tense with a slight shooting pain when it happens. I couldn't of got it seen to as i went travelling a week later for 6 months to Australia (I'm from England).

Anyways...When i got back (Febraury 2008) i got it looked at by the local Physio he explained that i will have to have surgery to repair the carpal so it doesn't keep popping out in so many words. Ive booked an appointment with the hospital for June to get it looked at by a specialist and then get a booking for the surgery.

I was very active before this accident, going to the gym twice a day and was hoping to start some sort of career in Basketball. Obviously this is a big blow for me now since i cant do any of this and has made me feel very down by the whole situation.

My question is this, How long will it take for me to be able to lift weights and play basketball again? Or will my wrist never be as strong enough to do such activities?

Any feedback would be great, thanks for your time and be looking foward to hear from you.

Richard

Hiya Richard

Welcome to Ablehere.Com

I am glad you've found this website!.

Myself &amp; Julie both suffer from Carpal Instability/Wrist Instability, &amp; We understand it's effects on your normal day to day activities, life, &amp; mental health!.

I am sorry to hear your suffering from Carpal Instability/Wrist Instability, it's oftent very hard to detect in plan X-rays &amp; MRI-Scans &amp; only shows up on Physical Examinations!.

Sadly there's no real cure for Carpal Instability/Wrist Instability, only ways to delay the worsening of the symptoms &amp; pain/discomfort,

So most surgery is drastic &amp; only able to slow down this disability &amp; it's effects!.

You should start doing Physiotherapy &amp; get a Wrist Splint with a Metal Palmar Plate in the splint &amp; where it has often as possible,

While doing twice a day or more Physiotherapy &amp; hand/wrist/finger strengthening Exercises &amp; take Painkillers!.

Some Hand Surgeons will not carry out for an wrist operations for Carpal Instability/Wrist Instability, &amp; if it doesn't show up on Plan X-rays &amp; MRI-Scans they may just choose not even examin your hand/wrist for signs of Carpal Instability/Wrist Instability.

Carpal Instability/Wrist Instability is often Rare &amp; Still Very Poorly Understood!.

You might want to speak to Julie as well &amp; read her post at: www.ablehere.com/component/option,com_jo...iew/id,2097/catid,47

I've suffered from: Mid Carpal Instability (MCI)/Palmar Midcarpal Instability (PMCI) since: 13-10-2002 &amp; had it confirmed by 3 Consultant Orthopaedic &amp; Trauma Upper-Limb &amp; Hand Surgeon's &amp; they've also confirmed it will never be painfree or fully recover even if an wrist operation was 100% successful &amp; I'd still have a wrist disability, &amp; it's only going to get worse over my life time!.

I've had 2 wrist operations, 1 was on: 29-10-2003 and that for an detailed diagnosis &amp; the 2nd was on: 17-03-2004 and was an: Ligament Tightening Wrist Operation with the use of on K-Wirer!.

I am having a new/expermental wrist operation in May 2008, as so far none of the standard wrist operations have all been unssuccessful

Your need to know what your Consultant Orthopaedic &amp; Trauma Upper-Limb &amp; Hand Surgeon, will diagnosis you with &amp; what type of treatments, surgies, if any!.

Take Care &amp; Take It Easy

Scott

Hi Scott, Thank you for the quick and detailed reply, i'm sorry to hear that your wrist hasn't been repaired, I hope it will one day. Fingers crossed. I hope the surgery for mine will help as i will miss my activities which i can't do at the moment which have been a huge part of my life, if not ill have to look at other things maybe play the guitar or something lol
I'll keep you updated in the future on how things turn out.

Richard

Hi Richard

I have mid carpal instability so understand what you are going through, to some extent, with pain, limitation of function and it's impact on your life.

I am happy to chat with you and share any info I have with you.

My MCI is not due to an injury it's just me but my consultant has said my job has made it as bad as it is now and I am having to retire on medical grounds.
I am having surgery on the 24th April (arthroscopy and most likely laser capsular shrinkage).

As Scott has said true MCI doesn't have a very good prognosis but maybe your injury is less severe. I expect you will undergo many tests when you see your specialist and he will decide the best surgery and let you know it's likely outcome. Hopefully for you it will be good news. Unfortunately it may be an idea to think of those new hobbies though because I imagine it is unlikely that you will be able to lift weights anymore.

Good luck and let us know how things pan out for you.
Julie

Hiya Richard

No problem for the quic reply

Hopefully your have some really good news when you see your Orthopaedic &amp; Trauma Upper-Limb &amp; Hand Surgeon, &amp; make sure you see an: Orthopaedic &amp; Trauma Upper-Limb &amp; Hand Surgeon, &amp; not just an: Orthopaedic &amp; Trauma Surgeon.

It make's a big difference

You ask both My &amp; Julie anything on MCI/PMCI!.

As MCI/PMCI is still so poorly miss understood, it's not always recorded correlty or reported to hospitals &amp; so on,

So it's therefore even harder to record the causes for MCI/PMCI,

As in certain journals &amp; medical books on MCI/PMCI say it only has to be a light trauma or through repitive movements, tasks, jobs, or both.

Some Orthopaedic &amp; Trauma Upper-Limb &amp; Hand Surgeon's, &amp; Orthopaedic &amp; Trauma Surgeon's, Doctors/Consultants, Hopsitals,

Will only accept MCI/PMCI after an motorbike accident or through a factured wrist as it will show up first time on plan X-rays &amp; MRI-Scans,

As MCI/PMCI is a soft tissue injury it won't show up on plan X-rays or MRI-Scans after a trauma, injury, accident, repitive movements, tasks, jobs,

Unless it was caused by a direct break or fracture the hand/wrist, then the instabilit can't be missed or ignored,

But if your MCI/PMCI is only soft tissue injury based, meaning no breaks or factures in the hand/wrist, then it will not show up on Paln X-rays or MRI-Scans for many years later, &amp; you need Physical Examinations of both hands/wrists, Stress X-rays, Dynamic MRI-Scans of both hands/wrists as MCI/PCMI starts of Dynamic I.E. only seen with movements, it later will change to static &amp; this is where years later it can be seen on Plan X-rays &amp; MRI-Scans,

Your likely to still have Plan X-Rays, MRI-Scans, Wrist Splint, Pysiotherapy, NAIDS, Wrist Arthoroscopy, Physical Examinations of both Hands/Wrists, Arms, Elbows, Shoulders, both sides of the Neck,

Before an Orthopaedic &amp; Trauma Upper-Limb &amp; Hand Surgeon will even diagnosis you with MCI/PMCI, or disucuss any other treatments or wrist operations, they may say the clunking, popping, snapping, clicking, Pain, Discomfort, Disability,

Is all in your head,

Or they might get an second opinion/view on your MCI/PMCI,

So I wouldn't hold your breath on having your wrist operation as quick as June 2008.

As most MCI/PMCI are unsuccessful, or still being studied in the long term outcomes/results!.

I can't see you ever being able to lift heavy weights again, but as your symptoms for MCI/PMCI have only been around for just over an year, you might have better chance with an wrist operation.

But you should increase this chance by doing twice a day hand/wrist Physiotherapy &amp; hand/wrist, finger strengthening Exercises, Get a Wrist Splint with a Metal Palmar Plate &amp; wear it for tasks/hobbies.

Buy stuff like this &amp; always start of with the light &amp; easiest:

www.physioroom.com/product/Digiflex_Fing...ener/2334/37856.html

www.physioroom.com/product/Hand_Therapy_Ball/2334/36813.html

www.physioroom.com/product/Therapeutic_P...tub_/2334/36815.html

Wrist Splints:

www.physioroom.com/product/Mueller_Wrist...int_/2035/35907.html

www.physioroom.com/product/Aircast_Stabi...osis/2035/38253.html

I hope this helps

Remember to read the medical journals on MCI/PMCI, Julie's story, my story, &amp; others!.

Take Care &amp; Take It Easy

Scott

Copeland_Supernatural wrote:

Hi there, ive just registered on this site and my problem is this...

In June 2007 i punched a punching bag which i injured myself by a bad technique.I thought i just sprained my hand and didn't dop anything about it, once the swelling went down my wrist still wasn't right. My carpal on the top of my hand keeps popping up and out when i clench my fist and tense with a slight shooting pain when it happens. I couldn't of got it seen to as i went travelling a week later for 6 months to Australia (I'm from England).

Anyways...When i got back (Febraury 2008) i got it looked at by the local Physio he explained that i will have to have surgery to repair the carpal so it doesn't keep popping out in so many words. Ive booked an appointment with the hospital for June to get it looked at by a specialist and then get a booking for the surgery.

I was very active before this accident, going to the gym twice a day and was hoping to start some sort of career in Basketball. Obviously this is a big blow for me now since i cant do any of this and has made me feel very down by the whole situation.

My question is this, How long will it take for me to be able to lift weights and play basketball again? Or will my wrist never be as strong enough to do such activities?

Any feedback would be great, thanks for your time and be looking foward to hear from you.

Richard

Hiya Richard

Try A new and innovative approach to immediate symptom relief for people with wrist instability (Traumatic or Non Traumatic).

carpalgloveorthosis.net/docs/cgoprescription.pdf