Download PDF
J Wrist Surg 2022; 11(03): 250-256
DOI: 10.1055/s-0041-1731817
Scientific Article

Radiocarpal Contact Pressures Are Not Altered after Scapholunate Ligament Tears

Hailey P. Huddleston
1   Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York
,
Joey S. Kurtzman
1   Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York
,
Kenneth H. Levy
1   Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York
,
Katherine M. Connors
1   Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York
,
Westley T. Hayes
1   Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York
,
Steven M. Koehler 
1   Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

Abstract

Background The scapholunate interosseous ligament (SLIL) couples the scaphoid and lunate, preventing motion and instability. Prior studies suggest that damage to the SLIL may significantly alter contact pressures of the radiocarpal joint.

Questions/Purposes The purpose of this study was to investigate the contact pressure and contact area in the scaphoid and lunate fossae of the radius prior to and after sectioning the SLIL.

Methods Ten cadaveric forearms were dissected distal to 1-cm proximal to the radiocarpal joint and a Tekscan sensor was placed in the radiocarpal joint. The potted specimen was mounted and an axial load of 200 N was applied over 60 seconds.

Results Sectioning of the SLIL did neither significantly alter mean contact pressure at the lunate fossa (p = 0.842) nor scaphoid fossa (p = 0.760). Peak pressures were similar between both states at the lunate and scaphoid fossae (p = 0.301–0.959). Contact areas were similar at the lunate fossa (p = 0.508) but trended toward an increase in the SLIL sectioned state in the scaphoid fossa (p = 0.055). No significant differences in the distribution of contact pressure (p = 0.799), peak pressure (p = 0.445), and contact area (p = 0.203) between the scaphoid and lunate fossae after sectioning were observed.

Conclusion Complete sectioning of the SLIL in isolation may not be sufficient to alter the contact pressures of the wrist.

Clinical Relevance Injury to the secondary stabilizers of the SL joint, in addition to complete sectioning of the SLIL, may be needed to induce altered biomechanics and ultimately degenerative changes of the radiocarpal joint.

Keywords

contact pressure - radiocarpal joint - scapholunate interosseous ligament - scapholunate joint - SLIL

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.




Publication History

Received: 06 December 2020

Accepted: 01 June 2021

Article published online:
14 July 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Short WH, Werner FW, Green JK, Sutton LG, Brutus JP. Biomechanical evaluation of the ligamentous stabilizers of the scaphoid and lunate: part III. J Hand Surg Am 2007; 32 (03) 297-309
    CrossrefPubMedGoogle Scholar
  • 2 Nikolopoulos FV, Apergis EP, Poulilios AD, Papagelopoulos PJ, Zoubos AV, Kefalas VA. Biomechanical properties of the scapholunate ligament and the importance of its portions in the capitate intrusion injury. Clin Biomech (Bristol, Avon) 2011; 26 (08) 819-823
    CrossrefPubMedGoogle Scholar
  • 3 Waters MS, Werner FW, Haddad SF, McGrattan ML, Short WH. Biomechanical evaluation of scaphoid and lunate kinematics following selective sectioning of portions of the scapholunate interosseous ligament. J Hand Surg Am 2016; 41 (02) 208-213
    CrossrefPubMedGoogle Scholar
  • 4 Salva-Coll G, Garcia-Elias M, Leon-Lopez MT, Llusa-Perez M, Rodríguez-Baeza A. Effects of forearm muscles on carpal stability. J Hand Surg Eur Vol 2011; 36 (07) 553-559
    CrossrefPubMedGoogle Scholar
  • 5 Van Overstraeten L, Camus EJ. The role of extrinsic ligaments in maintaining carpal stability - a prospective statistical analysis of 85 arthroscopic cases. Hand Surg Rehabil 2016; 35 (01) 10-15
    CrossrefPubMedGoogle Scholar
  • 6 Garcia-Elias M, Alomar Serrallach X, Monill Serra J. Dart-throwing motion in patients with scapholunate instability: a dynamic four-dimensional computed tomography study. J Hand Surg Eur Vol 2014; 39 (04) 346-352
    CrossrefPubMedGoogle Scholar
  • 7 Werner FW, Short WH, Green JK. Changes in patterns of scaphoid and lunate motion during functional arcs of wrist motion induced by ligament division. J Hand Surg Am 2005; 30 (06) 1156-1160
    CrossrefPubMedGoogle Scholar
  • 8 Padmore CE, Stoesser H, Langohr GDG, Johnson JA, Suh N. Carpal kinematics following sequential scapholunate ligament sectioning. J Wrist Surg 2019; 8 (02) 124-131
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Short WH, Werner FW, Fortino MD, Palmer AK, Mann KA. A dynamic biomechanical study of scapholunate ligament sectioning. J Hand Surg Am 1995; 20 (06) 986-999
    CrossrefPubMedGoogle Scholar
  • 10 Watson HK, Ballet FL. The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis. J Hand Surg Am 1984; 9 (03) 358-365
    CrossrefPubMedGoogle Scholar
  • 11 Daly BT, Werner FW, Cavallaro SM, Tucci ER, Harley BJ. Effect of push-up position on wrist joint pressures in the intact wrist and following scapholunate interosseous ligament sectioning. J Hand Surg Am 2018; 43 (04) 339-345
    CrossrefPubMedGoogle Scholar
  • 12 Blevens AD, Light TR, Jablonsky WS. et al. Radiocarpal articular contact characteristics with scaphoid instability. J Hand Surg Am 1989; 14 (05) 781-790
    CrossrefPubMedGoogle Scholar
  • 13 Johnson JE, Lee P, McIff TE, Toby EB, Fischer KJ. Scapholunate ligament injury adversely alters in vivo wrist joint mechanics: an MRI-based modeling study. J Orthop Res 2013; 31 (09) 1455-1460
    CrossrefPubMedGoogle Scholar
  • 14 Johnson JE, Lee P, McIff TE, Toby EB, Fischer KJ. Effectiveness of surgical reconstruction to restore radiocarpal joint mechanics after scapholunate ligament injury: an in vivo modeling study. J Biomech 2013; 46 (09) 1548-1553
    CrossrefPubMedGoogle Scholar
  • 15 Berger RA, Bishop AT, Bettinger PC. New dorsal capsulotomy for the surgical exposure of the wrist. Ann Plast Surg 1995; 35 (01) 54-59
    CrossrefPubMedGoogle Scholar
  • 16 Slater Jr. RR, Szabo RM, Bay BK, Laubach J. Dorsal intercarpal ligament capsulodesis for scapholunate dissociation: biomechanical analysis in a cadaver model. J Hand Surg Am 1999; 24 (02) 232-239
    CrossrefPubMedGoogle Scholar
  • 17 Gíslason MK, Stansfield B, Bransby-Zachary M, Hems T, Nash DH. Load transfer through the radiocarpal joint and the effects of partial wrist arthrodesis on carpal bone behaviour: a finite element study. J Hand Surg Eur Vol 2012; 37 (09) 871-878
    CrossrefPubMedGoogle Scholar
  • 18 Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil 1985; 66 (02) 69-74
    PubMedGoogle Scholar
  • 19 Koehler SM, Beck CM, Nasser P, Gluck M, Hausman MR. The effect of screw trajectory for the reduction and association of the scaphoid and lunate (RASL) procedure: a biomechanical analysis. J Hand Surg Eur Vol 2018; 43 (06) 635-641
    CrossrefPubMedGoogle Scholar
  • 20 Wu JZ, Herzog W, Epstein M. Effects of inserting a pressensor film into articular joints on the actual contact mechanics. J Biomech Eng 1998; 120 (05) 655-659
    CrossrefPubMedGoogle Scholar
  • 21 Bachus KN, DeMarco AL, Judd KT, Horwitz DS, Brodke DS. Measuring contact area, force, and pressure for bioengineering applications: using Fuji Film and TekScan systems. Med Eng Phys 2006; 28 (05) 483-488
    CrossrefPubMedGoogle Scholar
  • 22 Johnson JE, McIff TE, Lee P, Toby EB, Fischer KJ. Validation of radiocarpal joint contact models based on images from a clinical MRI scanner. Comput Methods Biomech Biomed Engin 2014; 17 (04) 378-387
    CrossrefPubMedGoogle Scholar
  • 23 Crisco JJ, Pike S, Hulsizer-Galvin DL, Akelman E, Weiss A-PC, Wolfe SW. Carpal bone postures and motions are abnormal in both wrists of patients with unilateral scapholunate interosseous ligament tears. J Hand Surg Am 2003; 28 (06) 926-937
    CrossrefPubMedGoogle Scholar
  • 24 Perez AJ, Jethanandani RG, Vutescu ES, Meyers K, Lee SK, Wolfe SW. Role of ligament stabilizers of the proximal carpal row in preventing Dorsal Intercalated Segment Instability: A cadaveric study. J Bone Joint Surg Am 2019; 101 (15) 1388-1396
    CrossrefPubMedGoogle Scholar
  • 25 Pang EQ, Douglass N, Kamal RN. Association of lunate morphology with carpal instability in scapholunate ligament injury. Hand (N Y) 2018; 13 (04) 418-422
    CrossrefPubMedGoogle Scholar
  • 26 Werner FW, Short WH, Green JK, Evans PJ, Walker JA. Severity of scapholunate instability is related to joint anatomy and congruency. J Hand Surg Am 2007; 32 (01) 55-60
    CrossrefPubMedGoogle Scholar