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Scapholunate instability: current concepts in diagnosis and management
1Department of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, NY, USA.
The Journal of Hand Surgery
|October 2, 2012
Summary
Injuries to the scapholunate ligament, a common cause of wrist instability, can lead to long-term dysfunction. Early intervention is key to restoring joint mechanics and preventing degenerative changes.
Area of Science:
- Orthopedics
- Hand Surgery
- Biomechanics
Background:
- Scapholunate joint injuries are the primary cause of carpal instability.
- Isolated scapholunate interosseous ligament injuries can initiate progressive carpal degeneration.
- Wrist dysfunction, lost work time, and activity interference are common consequences.
Purpose of the Study:
- To review the anatomy, kinematics, and biomechanics of the scapholunate articulation.
- To provide a framework for understanding scapholunate ligament instability.
- To propose a treatment algorithm for scapholunate instability.
Main Methods:
- Literature review focusing on scapholunate joint anatomy, biomechanics, and injury.
- Analysis of the progression of carpal instability following ligamentous injury.
- Development of a treatment algorithm based on injury stage and secondary damage.
Main Results:
- Detailed discussion of scapholunate joint anatomy and kinematics.
- Explanation of biomechanical properties influencing joint stability.
- Categorization of instability based on injury severity and degenerative changes.
Conclusions:
- Scapholunate ligament injuries necessitate intervention to restore ligament continuity and carpal kinematics.
- A staged treatment approach is proposed to manage scapholunate instability.
- Addressing these injuries can mitigate long-term wrist dysfunction and degenerative outcomes.
