title: Inter-carpal soft tissue entrapment. A possible explanation for chronic dorsal wrist pain.
abstract: This retrospective study evaluates the surgical treatment of a group of patients with unknown chronic dorsal wrist pain. The cause of their symptoms was interpreted as a painful entrapment of fibrous tissue in the radio-carpal and inter-carpal joints during specific movements. Between 1997 and 2001, 30 patients were treated by surgical excision of this tissue and 26 patients were traced for follow-up. Twenty-three patients were symptom free, or experienced major benefit from surgery. Wrist function measurements using the VAS scale showed improvement in 24 patients. Microscopic examination of the removed specimen shows fibrous tissue with non-specific changes. Inter-carpal soft tissue entrapment can explain the typical clinical findings in some patients with unknown chronic dorsal wrist pain. After careful selection, surgical excision of all entrapped tissue in the radio-carpal and mid-carpal joint may give relief of pain and improvement of wrist function.
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Haga Hospital, Leyenburg, Leyweg 275, 2545 CH The Hague, The Netherlands. a.terng@plchir.umcn.nl
authors.forename: S C A
authors.initials: SC
authors.lastname: Terng
authors.forename: K C
authors.initials: KC
authors.lastname: Kuypers
authors.forename: A R
authors.initials: AR
authors.lastname: Koch
mesh_terms: D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000503:physiopathology*; D002348:Carpal Bones / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D002648:Child; D003251:Constriction, Pathologic / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005355:Fibrosis; D006801:Humans; D017746:Joint Capsule / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014955:Wrist Joint / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery