Intervention for scapholunate instability is aimed at halting the degenerative process by restoring ligament integrity and normalizing carpal kinematics. Part 1 of this Current Concepts article reviewed the anatomy, kinematics, and biomechanical properties of the scapholunate ligament as well as its critical stabilizers. In this section, we provide a foundation for understanding the spectrum of scapholunate ligament instability and incorporate meaningful new anatomical insights that influence treatment considerations. These updates clarify the importance of the critical stabilizers of the scapholunate interval, ligament-specific considerations in scapholunate ligament reconstruction, and the risks of ligament disinsertion when surgically exposing the dorsal wrist. We propose a ligament-based treatment algorithm based on the stage of injury, degree and nature of ligament damage, and presence of arthritic changes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jhsa.2023.06.016 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Identification of degenerative precursors at the wrist with advanced imaging: current updates.
J Hand Surg Eur Vol
January 2025
Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
Articular malalignment and ulnocarpal impaction can progress to osteoarthritis in the wrist. This may be triggered by tears of the scapholunate ligament (rarely the lunotriquetral ligament) or the foveal lamina of the triangular fibrocartilage complex. In the pre-degenerative stages, radiographic findings are inconclusive, and symptoms may be absent or discrete.
View Article and Find Full Text PDFDo perilunate dislocations and fracture-dislocations result in different radiological outcomes following wrist alignment reconstruction? A single-center retrospective study including 51 patients with perilunate injuries.
Arch Orthop Trauma Surg
January 2025
Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany.
Introduction: Perilunate dislocations (PLD) and perilunate fracture-dislocations (PLFD) are high-energy wrist injuries often linked to significant post-traumatic osteoarthritis. This study aims to determine whether PLD and PLFD yield different radiological outcomes following surgical treatment while identifying prognostic factors for worse outcomes.
Materials And Methods: We retrospectively analyzed 51 patients treated for perilunate injuries between 2000 and 2022.
Anatomic C Scapholunate Reconstruction Technique: For Complete Dissociation of the Scapholunate Interval.
J Hand Surg Glob Online
November 2024
Department of Orthopedic Surgery, Crystal Clinic, Akron, OH.
This surgical technique article describes the anatomic C scapholunate reconstruction technique. It is indicated for complete acute or chronic scapholunate ligament dissociation. The technique addresses severe scapholunate interval gapping, ulnar translocation of the lunate, and rotational/dorsal intercalated segment instability.
View Article and Find Full Text PDFMinimally Invasive Radiolunate Imbrication Neutralization (MIRLIN) Procedure.
J Hand Surg Am
December 2024
Brisbane Hand and Upper Limb Research Institute, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Debate persists about the optimal surgical management of scapholunate dissociation. Many contemporary techniques address both the injured scapholunate ligament as well as the capsuloligamentous stabilizers necessary to prevent carpal instability and collapse. Here, we present a technique to reinforce or plicate the long radiolunate ligament, a critical stabilizer to the carpus.
View Article and Find Full Text PDFFront-to-Back Arthroscopic Repair of Complete Lunotriquetral Ligament Injuries: A Case Presentation and Algorithm for Arthroscopic Management of Intercarpal Ligament Injuries.
J Hand Surg Am
December 2024
Division of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery, Emory University, Atlanta, GA. Electronic address:
The lunotriquetral intercarpal ligament (LTIL) is an important structure that equalizes the forces on the lunate imparted through the scapholunate intercarpal ligament. The extension moment of the triquetrum balances the flexion force of the scaphoid, positioning the lunate for efficient load transfer from the hand to the wrist. In contrast to the scapholunate intercarpal ligament, the LTIL is strongest volarly, with the most critical region being associated with the volar ulnocapitate ligament.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!