Despite improved understanding of carpal mechanics, increased awareness of intercarpal ligament injuries, and improved techniques for treating carpal instability, post-traumatic inter-carpal osteoarthrosis remains a common problem. The authors have focused on specific patterns and regions of carpal osteoarthritis. When symptomatic treatments such as splinting, local injections, and anti-inflammatory medications fail, surgical intervention becomes an option. The surgical options of excision or limited fusion have limitations and potential complications. These operations must be critically evaluated to determine which are most effective. Even limited excisions such as of the pisiform, as suggested by Beckers and Koebke [54], may have significant functional consequences; however, when successful, these operations can provide pain relief, restore wrist stability, and improve function [7].

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