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Current practice in the diagnosis and treatment of carpal instability--results of a survey of Australian hand therapists.

A postal survey of all 85 full Australian Hand Therapy Association (AHTA) members was carried out to determine the current practice of the diagnosis and treatment of carpal instability by AHTA members. There was an 87% return rate. On average therapists saw 3.8 patients/month with carpal instability. Time from onset of pain or injury was a median of eight weeks (inter-quartile range 0-26 weeks). Ulnar pain was reported in 39% of patients, central pain in 17%, radial pain in 13%, and combined in 34%. Mean pain intensity at rest was 3.5/10 (SD 2.8), and with aggravating activity was 7.7 (SD 2.2). Forty-seven percent of patients reported difficulties with grip-related activities. Mean grip strength was 67% of the contralateral side. The most commonly used tests used were scaphoid shift, lunotriquetral ballotment, triangular fibrocartilage complex, and midcarpal stress tests. The most used treatments were patient education (advice and activity modification), splinting the wrist, and isometric exercising of the wrist musculature.