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Identifying scapholunate ligamentous injury
Author(s) -
Werner Frederick W.,
Wang Haoyu,
Short Walter H.,
Sutton Levi G.,
Rosenbaum Paula F.
Publication year - 2009
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.20749
Subject(s) - scapholunate ligament , lunate , wrist , medicine , ligament , cadaver , scaphoid bone , anatomy , range of motion , orthodontics , surgery
The first purpose of this study was to develop a noninvasive clinical tool that could predict whether the scapholunate interosseous ligament and other secondary stabilizing ligaments are injured in the presence of suspected scapholunate instability. The second purpose of this study was to determine which of those ligaments or ligament groups have been injured. Kinematic and three‐dimensional (3D) meaurements from 62 cadaver wrists moved in a wrist joint motion simulator were used to develop various neural network predictive models. One group of models was based on angular changes in scaphoid and lunate motion before and after ligament sectioning (representing scapholunate instability). A second group of models was based on changes in the minimum distance between the scaphoid and lunate as well as other 3D gap measurements. The models, based on the scaphoid and lunate angular data, could predict with a 93% accuracy rate whether the wrist ligaments were intact. These models could also predict whether it was the dorsal ligaments or the volar ligaments that were sectioned 84% of the time. The models worked best using data with the wrist in 10 to 30 degrees of wrist flexion. The viability of a CT‐based predictive model has been demonstrated by obtaining high prediction rates, sensitivity, specificity, and kappa statistic values. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:394–399, 2009