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Intercarpal ligamentous laxity in cadaveric wrists.
T R Rimington1, S G Edwards, T S Lynch
1Department of Orthopaedic Surgery, Georgetown University Hospital, 3800 Reservoir Road, 1 Main West, Washington, DC 20007, USA.
The Journal of Bone and Joint Surgery. British Volume
|November 2, 2010
Summary
Wrist interosseous ligament laxity increases with age but not with lunate morphology or joint angles. A wider physiological range exists, suggesting a need for modified classifications to distinguish normal from pathological instability.
Area of Science:
- Orthopedics
- Anatomy
- Biomechanics
Background:
- Interosseous ligaments are crucial for wrist stability.
- Understanding ligamentous laxity is key for diagnosing wrist instability.
Purpose of the Study:
- Define the range of interosseous ligament laxity in cadaveric wrists.
- Correlate laxity with age, lunate morphology, scapholunate gap, and scapholunate angle.
Main Methods:
- Evaluated 83 fresh-frozen cadaveric wrists.
- Recorded scapholunate gap and angle.
- Performed arthroscopy to grade scapholunate interosseous ligament (SLIL) and lunotriquetral interosseous ligament (LTIL) laxity and assess lunate morphology.
Main Results:
- SLIL laxity grades ranged from I to IV (5% to 48%); LTIL laxity grades ranged from I to IV (1% to 48%).
- Both SLIL and LTIL laxity increased with age and decreased with female gender.
- No correlation found between ligament laxity and lunate morphology, SL gap, or SL angle.
Conclusions:
- The physiological laxity range of intercarpal ligaments is broader than previously described.
- Age-related progression of laxity is evident in SL and lunotriquetral joints.
- The Geissler classification aids in describing laxity, but a modified approach is needed to differentiate physiological from pathological instability.
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