腕不稳定是一类严重而复杂的腕关节疾患，一般由不同程度和类型的腕关节损伤或病理改变引起。舟月不稳定是最常见的腕不稳定类型，其他损伤类型包括月三角不稳定、腕中关节不稳定、桡腕不稳定和月骨周围损伤等。腕不稳定的诊断与治疗相对困难，是腕关节领域的研究热点。近年来，随着对腕不稳定病理机制的理解深入，出现了许多更符合腕关节解剖和运动学的新手术方法。同时，随着腕关节镜技术的快速发展，许多传统的切开手术正不断向腕关节镜辅助下的微创手术演进。笔者对腕不稳定的诊断和治疗进展进行阐述，讨论腕不稳定诊疗过程中的难点和争议问题，为临床工作提供参考。“,”Carpal instability is a set of complex and important wrist pathology, which is usually secondary to different injury severities and patterns to the wrist joint or pathological changes. Scapholunate instability is the most common type of carpal instability, and other prevalent patterns include lunotriquetral instability, midcarpal instability, radiocarpal instability and perilunate injuries. The diagnosis and treatment of carpal instability is relatively difficult, which has drawn much attention in the field of wrist surgery. With deeper understanding of pathological mechanism of wrist instability, there reported new surgical procedures with better suitability to anatomical character and kinematics to repair or reconstruct ligaments. Also, with the rapid development of wrist arthroscopy techniques, many traditional open procedures can now be accomplished in a minimally invasive approach, under assistance of wrist arthroscopy. The authors review the progress in diagnosis and treatment of carpal instability in recent years and discuss the existed confusion so as to provide a reference for clinical work.