Chronic wrist pain.

Abstract

Nonarticular chronic wrist pain continues to be a challenging subject in which interest and knowledge are increasing. Although many more excellent articles could have been included in this review, an attempt is made to discuss papers that have impact on the recognition, diagnosis, and treatment of various wrist problems. Developments in diagnostic algorithms and refinements in the use of imaging and arthroscopic tools are reviewed. Arthroscopy provides exciting direct visual information and therapeutic opportunities for triangular fibrocartilage complex disruptions and lunatotriquetral ligament pathology. A new carpal instability analysis system is proposed to allow better comparison of results reported in the literature. Comprehensive evaluation and treatment of the rheumatoid wrist are revisited. The effectiveness of operative treatment for midcarpal instability and distal radioulnar joint osteoarthritis continues to be assessed. Sports-related chronic wrist injuries from golf, trampolining, and gymnastics, as well as newer recreational activities such as in-line skating, are rapidly gaining the recognition they deserve.