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Carpal instability: Types, Place of VISI & DISI

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  Key word: Carpal instability, Data base: Pubmed Wrist anatomy- extrinsic & and intrinsic ligaments The extrinsic (radiocarpal) and intrinsic (intercarpal) ligaments maintain carpal stability. The major extrinsic ligaments are the radioscaphocapitate, radiolunotriquetral, short radiolunate, and dorsal radiocarpal ligaments. The scapholunate and lunotriquetral ligaments are the most important intrinsic ligaments and the primary wrist stabilizers. The most common causes of carpal instability are unstable fracture of the scaphoid, scapholunate dissociation, and lunotriquetral dissociation (7). Let us discuss the causes of carpal instability. Classification of carpal instability is presented below is based on anatomic and kinematic characteristics of the wrist. A classification of the subtle patterns of carpal instability is presented below.   Navarro's concept of the carpus (1921): Carpals of wrist are arranged in 3 vertical longitudinal columns: lateral (scaph