Lunotriquetral injuries

Abstract

Lunotriquetral injury is an important consideration in the evaluation of ulnarsided wrist pain. An understanding of the anatomy, kinematics, and pathomechanics of this injury assists in elucidating the diagnosis through history and physical examination. The use of appropriate radiographic imaging may provide additional support for the diagnosis. Arthroscopy has emerged as not only the gold standard for diagnosis of this injury, but also as an effective means of treatment. Treatment decisions must be based on both the degree of severity and acuity of the injury. Although the majority of patients will do well with nonoperative management, the indications for surgery and the varied outcomes of surgical management are discussed.

Association of lunate morphology, sex, and lunotriquetral interosseous ligament injury with radiologic measurement of the capitate-triquetrum joint

“…While the scapholunate ligament is one intrinsic source of support for the proximal carpal row, static carpal stability also depends on LTIL integrity [23]. Disruption of the LTIL – a common cause of ulnar-sided wrist pain – has predominantly been investigated using arthroscopy, arthrography, or MR arthrography because presentation on conventional radiographs was thought to be limited to subtle changes within the proximal carpal row [6]. Our data demonstrate that C-T distance may be used in preliminary clinical assessment to justify the use of a ‘gold standard’ imaging modality when investigating suspicion of LTIL injury with ulnar-sided wrist pain.…”

“…Disruption of the LTIL may therefore introduce dysfunctions in carpal kinematics and changes in static carpal alignment beyond the proximal carpal row. Early detection of LTIL disruption, a common cause of ulnar-sided wrist pain, is essential for optimal treatment; chronic injury can potentially lead to volar intercalated segmental instability, at which point more complicated surgical interventions may become necessary [6-8]. …”

Ulnar taraflı el bileği ağrısında muayene ve tanı

“…Bu ön-arka yöndeki basınç ile ağrı, krepitasyon ve eklemde oluşan anormal deplasman, lunotrikuetral interosseöz bağın yaralanma olasılığını düşündürür (Şekil 7). [11]…”

“…Pisiform kemiği dorsale itilmesi ile oluşan makaslama kuvveti lunotrikuetral eklemde ağrıya neden olur (Şekil 8). [11]…”