Midcarpal Instability: From Testing to Treatment (Recorded Webinar)

Video Runtime: 63 Minutes; Learning Assessment Time: 18 Minutes

What is one of the most challenging wrist conditions we see in the hand therapy clinic? Is it a patient with a crush injury involving multiple fractures and tendon lacerations, or is it the young girl involved in gymnastics who presents with progressive onset of wrist pain? Wrist instability can be a difficult condition to treat. This webinar will be covering the intricate mechanics of midcarpal instability and the two types of clinical presentations: midcarpal VISI (volar intercalated segmental instability) and the less common midcarpal DISI (dorsal intercalated segmental instability). Clinical testing for each of these conditions will be covered as well as evidence-supported treatment interventions including orthotic management, muscular engagement, and the progression with proprioceptive training. Develop tools to systematically address midcarpal instability that you can readily apply in the clinic

Learning Objectives

• Through clinical testing, distinguish between the two types of midcarpal instability: VISI and DISI
• Determine which type of orthosis will be beneficial for a midcarpal VISI versus a midcarpal DISI to promote stability with daily activities
• Formulate a treatment program for a patient with a midcarpal VISI and midcarpal DISI to promote joint stability based on evidence-supported understanding of muscle groups
• Implement proprioceptive training to optimize stability for higher-level tasks, such as gripping and weight bearing, to facilitate the patient returning to previous occupations