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J Wrist Surg 2021; 10(06): 467-475
DOI: 10.1055/s-0041-1723792
Special Review: The Scapholunate Dilemma

Histomorphology of the Subregions of the Scapholunate Interosseous Ligament and Its Enthesis

Mei Yen Liew 
1   Department Plastic Surgery, Hooper Hand Unit, St John's Hospital, Livingston, United Kingdom
2   Department of Anatomy, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Scotland, United Kingdom
,
Jeremy W. Mortimer
2   Department of Anatomy, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Scotland, United Kingdom
,
Jennifer Z. Paxton
2   Department of Anatomy, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Scotland, United Kingdom
,
Stephen Tham
3   Department of Plastic and Hand Surgery, St Vincent's Hospital, Hand and Wrist Biomechanics Laboratory/O'Brien Institute, Melbourne, Australia
,
Philippa A. Rust
1   Department Plastic Surgery, Hooper Hand Unit, St John's Hospital, Livingston, United Kingdom
2   Department of Anatomy, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Scotland, United Kingdom
› Author Affiliations Funding This research received grants from Hand and Wrist Medical Research Foundation, a charitable body registered in Melbourne, Australia and grants from Mr Hamilton’s Research and Development Fund, St John’s Hospital, Edinburgh, during the conduct of the study.
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Abstract

Background The scapholunate interosseous ligament (SLIL) has three subregions: dorsal, proximal, and volar. The SLIL enthesis has not previously been studied despite its important mechanical function in wrist joint biomechanics.

Questions/Purposes This study aims to compare the histomorphological differences between the SLIL subregions, including at their entheses. Three questions are explored: Do the gross dimensions differ between SLIL subregions? Does the enthesis qualitatively, and its calcified fibrocartilage (CF) quantitatively, differ between (a) SLIL subregions and (b) scaphoid and lunate attachments?

Methods Twelve fresh-frozen human cadaveric wrists were dissected and the gross dimensions of the SLIL subregions measured. Subregions were histologically processed for morphological and compositional analyses, including quantification of enthesis CF area.

Results The dorsal subregion was the thickest. The dorsal and volar subregions had fibrocartilaginous entheses, while the proximal subregion was attached to articular cartilage. The dorsal subregion had significantly more CF than the volar subregion. There was no significant difference in the enthesis CF between scaphoid and lunate attachments in the three subregions.

Conclusions There are significant morphological differences between the SLIL subregions. The dorsal subregion has the largest amount of CF, which is consistent with the greater biomechanical force subjected to this subregion. The similar histomorphology of the ligament at the scaphoid and lunate entheses suggests that similar biomechanical forces are applied to both attachments.

Clinical Relevance The histomorphological results confirm that the dorsal subregion is the strongest of the three subregions. The results from the entheseal region may have important implications in the study of graft incorporation during SLIL reconstruction.

Keywords

scapholunate - ligament - enthesis - morphology - histology

Ethical Approval

No ethical review process was required for undertaking this study. All specimens used in this study were obtained from Anatomy, The University of Edinburgh in accordance with the Human Tissue (Scotland) Act 2006.


Note

This work was performed at the University of Edinburgh, Scotland, United Kingdom.




Publication History

Received: 01 May 2020

Accepted: 29 December 2020

Article published online:
16 February 2021

© 2021. Thieme. All rights reserved.

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