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Ulnar-sided perilunate instability: an anatomic and biomechanic study
S F Viegas1, R M Patterson, P D Peterson
1Division of Orthopaedic Surgery, University of Texas Medical Branch, Galveston 77551.
The Journal of Hand Surgery
|March 1, 1990
Summary
A new staging system for ulnar-sided perilunate instability is proposed. It categorizes instability based on ligament disruption severity and the presence of volar intercalated segment instability deformity.
Area of Science:
- Orthopedics
- Anatomy
- Biomechanics
Background:
- Ulnar-sided wrist pain is common.
- Perilunate instability can lead to significant dysfunction.
- A clear staging system is needed for accurate diagnosis and treatment.
Purpose of the Study:
- To develop and present a novel staging system for ulnar-sided perilunate instability.
- To correlate ligamentous injury patterns with clinical and radiographic findings.
Main Methods:
- Cadaveric dissections were performed to identify ligamentous structures.
- Load studies were conducted to simulate wrist instability.
- A staging system was developed based on observed injury patterns.
Main Results:
- Stage I involves partial/complete lunotriquetral interosseous ligament disruption without deformity.
- Stage II includes complete lunotriquetral interosseous and palmar lunotriquetral ligament disruption with dynamic deformity.
- Stage III involves complete disruption of multiple ligaments and static deformity.
Conclusions:
- The proposed staging system provides a framework for classifying ulnar-sided perilunate instability.
- This system aids in understanding the progression of instability.
- It can guide clinical decision-making and treatment strategies.