Non-dissociative Carpal Instability in Distal Radius Fractures

Non-dissociative carpal instability in distal radius fractures may present as a result of concomitant extrinsic carpal ligamentous lesions that destabilize the wrist. These injuries need special attention and an early diagnosis to guarantee an adequate result. It usually occurs in young patients sustaining an intra-articular fracture or fracture dislocation of wrist after high energy of trauma and has also been described occurring with scaphoid fractures. It is often identified in postoperative radiographs, presenting with either a CIND-T-palmar or a CIND-T-dorsal pattern. If diagnosed early, radiocarpal ligament repair and immobilization are recommended to restore normal carpal alignment. In chronic and fixed nonreducible lesions, or in the presence of degenerative changes, salvage procedures such as a radiolunate or radioscapholunate arthrodesis are indicated.