Lunotriquetral instability is treated based upon degree of instability and concomitant pathology although there is no consensus on treatment of lunotriquetral instability. Lunotriquetral instability, with or without concomitant pathology, has been surgically managed with arthrodesis, ligament graft reconstruction, ligament repair, percutaneous pinning, and ulnar shortening.
In this arthroscopic approach, management of lunotriquetral instability combines arthroscopic soft tissue management with arthroscopic reduction of the lunotriquetral joint and percutaneous pinning. Arthroscopic suture plication of the ulnocarpal ligaments shortens ligament length to act as a checkrein to excessive lunotriquetral motion similar to ligament tightening associated with ulnar shortening. Ligament plication with arthroscopic lunotriquetral reduction and pinning is useful for treatment while minimizing motion losses after surgery and reducing surgical exposure.
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