Carpal kinematics and instability: A clinical and anatomic primer

The complex anatomy of the wrist can be difficult to comprehend, and concepts of normal and abnormal motion may be difficult to convey to students. A conceptual framework may aid understanding in this difficult area. The key concept is that of the proximal carpal row as an intercalated segment stabilized by ligaments. On this foundation are added concepts of normal, synchronous, proximal row movement and analysis of abnormal movements. Abnormal movements are characterized by their direction and severity. The final step in analysis is localization of ligament abnormality, determining first the general class of ligament injured (extra‐articular/intra‐articular), then the specific location (proximal/distal, medial/lateral, anterior/posterior), and finally the specific ligament name.