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Wrist kinetics after scapholunate dissociation: the effect of scapholunate interosseous ligament injury and persistent scapholunate gaps
Author(s) -
Tang Jin Bo,
Ryu Jaiyoung,
Omokawa Shohei,
Wearden Stanley
Publication year - 2002
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 - 10.1016/s0736-0266(01)00118-8
Subject(s) - wrist , scapholunate ligament , flexor carpi ulnaris , extensor carpi ulnaris , anatomy , medicine , ligament , tendon , elbow , ulnar nerve
The purpose of this study was to investigate the effects of cutting of the scapholunate interosseous ligament (SLIL) and persistent widening of the scapholunate (SL) joint on changes in moment arms of the principal wrist motor tendons. In seven fresh frozen cadaveric upper extremities, excursions of the extensor carpi radialis longus (ECRL) and brevis (ECRB), extensor carpi ulnaris (ECU), flexor carpi radialis (FCR), and flexor carpi ulnaris (FCU) were recorded simultaneously with wrist joint angulation during wrist flexion–extension and radioulnar deviation. Tendon excursions were measured in intact wrists, then in the wrists with complete SLIL sectioning and in those with moderate or severe persistent SL joint widening. The data were converted to moment arms of the tendons. The results showed that moment arms of the ECRL and ECRB tendons after SLIL sectioning were, respectively, 110 ± 6% and 105 ± 3% of those in the intact wrist. In the wrists with moderate or severe SL joint widening, moment arms of the flexors significantly increased ( P < 0.01 and P < 0.001, respectively). During radioulnar deviation, moment arms of the ECRL, ECRB, ECU, and FCU tendons decreased after SLIL sectioning and the SL joint widening. However, moment arms of the FCR tendon significantly increased 122 ± 23% after the SLIL section, 133 ± 28% after the moderate SL joint widening, and 138 ± 24% after the severe SL joint widening compared with those of the intact wrists. This study demonstrated that integrity of the SLIL and appropriate SL joint space are important for mechanics of wrist motor tendons. Loss of integrity of the SLIL and persistent SL joint widening increase mechanical effects of the radial side wrist motor tendons, which may contribute to the pathomechanics of scaphoid malrotation, scapholunate advanced collapse, and early osteoarthritis in the radioscaphoid joint interface seen in SL dissociation. The results also suggest that reduction of the displaced SL joint is imperative to the recovery of wrist kinetics after SL dissociation. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.