Radial Wrist Extensors as a Dynamic Stabilizers of Scapholunate Complex

Journal Title: Polish Journal of Surgery - Year 2013, Vol 85, Issue 8

Abstract

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. Key words: scapholunate instability, scapholunate dissociation, rotatory subluxation of the scaphoid,

Authors and Affiliations

Ahmed Elsaftawy

Keywords

Related Articles

Damage of central catheters in home parenteral nutrition patients

According to the ESPEN and ASPEN guidelines, in the case of a long-term (>3-month) parenteral nutrition should be administered via a subcutaneous central venous catheter (CVC). There are three types of mechanical complic...

Resection and simultaneous reconstruction of the infrarenal aorta and inferior vena cava (case report)

A non-standard surgicall approach in malignant retroperitoneal tumor treatment was used, which includes simultaneous resection and reconstruction of the infrarenal segment of aorta and inferior vena cava. The total vascu...

Surrogate and clinical endpoints for studies in peripheral artery occlusive disease: Are statistics the brakes?

Background: The aim of this review is to present the available clinical and surrogate endpoints that may be used in future studies performed in patients with peripheral artery occlusive disease (PAOD). Importantly, we de...

Risk factors in reoperations in colorectal surgery

Background: Reoperations in colorectal surgery are usually a consequence of major surgical complications. Recently, the rate of reoperation has been proposed as a marker of surgical performance. Yet, the incidence of re-...

Download PDF file
  • EP ID EP74330
  • DOI 10.2478/pjs-2013-0069
  • Views 147
  • Downloads 0

How To Cite

Ahmed Elsaftawy (2013). Radial Wrist Extensors as a Dynamic Stabilizers of Scapholunate Complex. Polish Journal of Surgery, 85(8), 452-459. https://europub.co.uk/articles/-A-74330