This 1993 narrative review by Bednar and Osterman systematically addresses carpal instability — a common but diagnostically challenging cause of wrist pain and disability — by connecting wrist anatomy and carpal kinematics to specific instability patterns, radiographic criteria, and a time-based treatment algorithm.
When a patient presents with wrist pain after a fall and initial radiographs look normal, don't dismiss it as a sprain — systematically assess scapholunate angle, gap, and ring sign, and use the time-from-injury framework to guide whether arthroscopic repair, open ligament reconstruction, or arthrodesis is appropriate.
This 1993 narrative review by Bednar and Osterman systematically addresses carpal instability — a common but diagnostically challenging cause of wrist pain and disability — by connecting wrist anatomy and carpal kinematics to specific instability patterns, radiographic criteria, and a time-based treatment algorithm.
When a patient presents with wrist pain after a fall and initial radiographs look normal, don't dismiss it as a sprain — systematically assess scapholunate angle, gap, and ring sign, and use the time-from-injury framework to guide whether arthroscopic repair, open ligament reconstruction, or arthrodesis is appropriate.