Carpal kinematics of lunotriquetral dissociations

The purpose of this study is to investigate the carpal kinematics after serial arthroscopic sectioning of the ligaments at the lunotriquetral joint, without damaging the capsule and other soft tissues of the wrist. Six cadaver wrists were studied and a custom designed three-dimensional mechanical digitizer was utilized. Three sets of digitization were performed for a normal state, after arthroscopic sectioning of lunotriquetral interosseous ligament (stage A), and after further sectioning of volar radiolunotriquetral ligament (stage B). Motion of the scaphoid, lunate, triquetrum, capitate and hamate was studied. The results indicated that the motion of the triquetrum was significantly increased at stage A, particularly after 15 degrees of ulnar deviation. An increased motion at the lunotriquetral joint was observed at stage B, which was mainly due to the significantly decreased lunate extension motion and the increased triquetrum extension motion during wrist extension. This study suggested that the lunotriquetral interosseous ligament plays the most important role for the stabilization of the lunotriquetral joint during wrist ulnar deviation, while the volar radiolunotriquetral ligament may function as a stabilizer for the lunotriquetral joint during wrist extension.