Palmar midcarpal instability

33yr old female with 3 year long history of right ulnar sided wrist pain with significant popping. No history of trauma.

The first ortho doctor I went to thought it was carpal tunnel and me, being an idiot, agreed to do the surgery because they said I had it. After surgery I still had significant ulnar sided wrist pain with the popping. Second Ortho doctor - I get X-rays which show significant negative ulnar deviation and he assumed I had a TFCC tear. I get a wrist widget - no improvement. I go back to get a steroid injection in my wrist -no improvement. I go back to get an MRI with dye which confirmed the TFCC tear. i get a cast for 6 weeks - no improvement (note with the cast I was still able to pop my wrist). Third Ortho doctor I go through because the second Ortho doctor said I'd need my anatomy corrected prior to my TFCC repair, otherwise it'd just rip again. The third Ortho doctor retakes X-rays and said there was no need to correct the deviation as there was no bones rubbing on one another and it's more of a "salvage" procedure anyways. I agree now to do a TFCC arthroscopic debridement surgery. 4 days after the surgery in a splint - I get the same popping I was originally having on my ulnar side. Post op appointments nobody was really taking me seriously about the popping so I took videos of it and showed them. I get a CT taken to see if my ECU is busted or if there's anything we are missing - CT just showed bone abnormalities that we saw on the original MRI. I go back in for a follow up and he realizes I have palmar midcarpal instability and this has likely been my primary issue all along, that the TFCC was just an incidental finding. He wants to now do a reconstruction surgery in my wrist to tighten it up and he said he thinks the popping is my ECU sliding over my wrist bone. This would not be an arthrodesis but using a tendon from somewhere else and he mentioned temporary pins.

With this being my third wrist surgery in a row is there anything else I could be missing? Should I NOT do this surgery?My left wrist is starting to snap, but my dominant hand is worse. I have a terrible grip, my arm is weak. Everything I've read basically say to not do surgery for midcarpal instability because of the outcomes usually being poor. He wanted to refer me to another orthopedic doctor but I'm done being tossed around. I've got a growing collection of braces as well. I also I forgot to add I did 2 rounds of PT that didn't help me as I think we were fixing a TFCC tear when I had midcarpal instability the entire time.

Posted Feb 18, 2025, 8:55 PM UTC

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