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2013 | 85 | 8 | 452-459
Tytuł artykułu

Radial Wrist Extensors as a Dynamic Stabilizers of Scapholunate Complex

Autorzy
Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Wrist stabilization is ensured by the complex of stabilizers, both static (intrinsic and extrinsic ligaments) and dynamic ones (flexor and extensor sinews of the wrist). Extrinsic carpal ligaments link both carpal rows with forearm, while the intrinsic ones connect individual carpal bones. From among intrinsic ligaments, the most significant from clinical point of view is scapholunate ligament (scapholunate lig. - SL). Instability of the SL resulting from SL ligament tear is the most frequent type of carpal instability. If untreated or undiagnosed, it may lead to destabilization of the carpal rows, and in the final stage to massive degenerative changes with SLAC (scapholunate advanced collapse). The aim of the study was to present a hypothesis of a possible influence of radial extensors of the wrist as dynamic stabilizers for SL complex, based on which it is possible to discern the partial ligament tear with accompanying damage of static stabilizers of the complex. Material and methods. This hypothesis was based on radiological tests carried out on 5 patients, with acute partial SL ligament tear, which was confirmed during wrist arthroscopy. The outcome was presented as well, with its visualization in radiological tests. Results. The picture of rotary subluxation of the scaphoid -signet ring sign in PA view and strengthening in stress position (clenched fist) was demonstrated in all 5 patients. In 2 patients who had wrist arthroscopy performed it was observed that the palmar and proximal part of SL ligament were injured, yet no damage of dorsal part was reported. In MRI tests of these patients, an additional injury of dorsal intercarpal ligament was revealed. Conclusions. Correction of the scaphoid reduction in position of clenched fist may result from influence of radial extensors of the wrist (both short and long) as dynamic stabilizers of SL complex. This imagining is a completion of the radiological symptoms so far occurring in this SL instability. In case of acute, partial scapholunate ligament tear, reduction of scapholunate subluxation and its internal fixation with the lunate and capitate for a 6-week period may be an optional procedure
Wydawca

Rocznik
Tom
85
Numer
8
Strony
452-459
Opis fizyczny
Daty
wydano
2013-08-01
online
2013-09-05
Twórcy
  • Department of General Surgery, Centre of Limbs Replantation, Microsurgery and Hand Surgery at St. Hedwig Hospital in Trzebnica, elsaftawyahmed@gmail.com
Bibliografia
  • 1. Anatomy and Biomechanics Committee of the IFSSH. Position Statement: Definition of Carpal Instability. J Hand Surg 1999; 24A: 866-67.
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  • 14. Blatt G: Capsulodesis in reconstructive hand surgery. Dorsla capsulodesis for the unstable scaphoid and volar capsulodesis following excision of the distal ulna. Hand Clin 1987; 3(1): 81-102.
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  • 16. Horii E, Garcia-Elias M, An KN et al.: A kinematic study of lunotriquetral dissociations. J HandSurg Am 1991; 16(2): 355-62.
  • 17. Cooney WP, Linsceid RL , Dobyns JH: Carpal instability: treatment of ligament injuries of the wrist. Instr Course Lect 1992; 41: 33-44.[PubMed]
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  • 19. Van Den Abbeele KL , Loh YC , Stanley JK et al.: Early results of a modified Brunelli procedure for scapholunate instability. J Hand Surg Br 1998; 23(2): 258-61.
  • 20. Garcia-Elias M: Treatment of scapho-lunate instability. Ortop Traumatol Rehabil 2006 28; 8(2): 160-68.
  • 21. Garcia-Elias M, Lluch AL, Stanley JK: Threeligament tenodesis for the treatment of scapholunate dissociation: indications and surgical technique. J Hand Surg Am 2006; 31(1): 125-34.[Crossref]
  • 22. Harvey EJ, Berger RA, Osterman AL et al.: Bone-tissue-bone repairs for scapholunate dissociation. J Hand Surg 2007; 32A: 256-64.[WoS]
  • 23. Szabo RM , Slater RR , Palumbo CF , Gerlach T: Dorsal intercarpal ligament capsulodesis for chronic, static scapholunate dissociation: clinical results. J Hand Surg 2002; 27: 978-84.
  • 24. Janeta CL , An KN , Linsceid RL et al.: The role of the scapho-trapezial-trapezoidal ligament complex on scaphoid kinematics. W edycji: Schuind F, An KN, Cooney WP III i wsp. Advances in the Biomechanics of the Hand and Wrist. New York, NY: Plenum Pres; 1994: 345-61.
  • 25. Salva-Coll G, Garcia-Elias M, Llusa-Perez M et al.: A The role of flexor carpi radialis muscle in scapholunate instability. J Hand Surg Am 2011; 36(1): 31-36.[Crossref]
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Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2013-0069
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