Carpal Instability: Anatomy, Kinematics, Imaging, and                     Classification

Flores, Dyan V.; Umpire, Darwin Fernández; Gómez, Catalina Mejía; Saad, Thales; Cerezal, Luís; Pathria, Mini N.

doi:10.1148/rg.2021210044

Cited by 5 publications

(2 citation statements)

References 11 publications

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“…Variable lunate trajectories may explain this finding. In complete scapholunate dissociation, the lunate undergoes rotational and deviational motion [ 24 ]. As outlined above, insufficiency of the SLL decreases radial traction on the lunate, which is pulled towards the triquetrum by the intact lunotriquetral ligament and follows the natural motion of the triquetrum into extension [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Dynamic assessment of scapholunate ligament status by real-time magnetic resonance imaging: an exploratory clinical study

Wilms,

Radke,

Abrar

et al. 2023

Skeletal Radiol

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Objective Clinical-standard MRI is the imaging modality of choice for the wrist, yet limited to static evaluation, thereby potentially missing dynamic instability patterns. We aimed to investigate the clinical benefit of (dynamic) real-time MRI, complemented by automatic analysis, in patients with complete or partial scapholunate ligament (SLL) tears. Material and methods Both wrists of ten patients with unilateral SLL tears (six partial, four complete tears) as diagnosed by clinical-standard MRI were imaged during continuous active radioulnar motion using a 1.5-T MRI scanner in combination with a custom-made motion device. Following automatic segmentation of the wrist, the scapholunate and lunotriquetral joint widths were analyzed across the entire range of motion (ROM). Mixed-effects model analysis of variance (ANOVA) followed by Tukey’s posthoc test and two-way ANOVA were used for statistical analysis. Results With the increasing extent of SLL tear, the scapholunate joint widths in injured wrists were significantly larger over the entire ROM compared to those of the contralateral healthy wrists (p<0.001). Differences between partial and complete tears were most pronounced at 5°–15° ulnar abduction (p<0.001). Motion patterns and trajectories were altered. Complete SLL deficiency resulted in complex alterations of the lunotriquetral joint widths. Conclusion Real-time MRI may improve the functional diagnosis of SLL insufficiency and aid therapeutic decision-making by revealing dynamic forms of dissociative instability within the proximal carpus. Static MRI best differentiates SLL-injured wrists at 5°–15° of ulnar abduction.

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Section: Discussionmentioning

confidence: 99%

Dynamic assessment of scapholunate ligament status by real-time magnetic resonance imaging: an exploratory clinical study

Wilms,

Radke,

Abrar

et al. 2023

Skeletal Radiol

View full text Add to dashboard Cite

show abstract

“…With failure of the scapholunate interosseous ligament or partial tear of the dorsal intercarpal ligament, dorsal radiocarpal ligament, or a critical volar ligament, such as the scaphotrapeziotrapezoid ligament or the long radiolunate ligament, there is loss of the normal alignment and consequent movement between the scaphoid and lunate. With axial load, the scaphoid preferentially flexes volarly, while the lunate, being pulled by the triquetrum with an intact lunotriquetral ligament, dorsiflexes (arrows) (Used with permission from Flores et al, 2021 103 ). …”

Section: Biomechanicsmentioning

confidence: 99%