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Scaphoid kinematics in scapholunate instability: a dynamic CT study.

Melanie Amarasooriya1, Rami Al-Dirini2, Kimberley Bryant3

  • 1College of Medicine and Public Health, Flinders University of South Australia, Adelaide, South Australia, Australia. amar0041@flinders.edu.au.

Skeletal Radiology
|March 23, 2023
PubMed
Summary

In scapholunate instability (SLI), the scaphoid bone moves with the distal carpal row. Dynamic CT scans revealed altered scaphoid alignment and motion in SLI wrists, supporting this hypothesis and informing surgical techniques.

Keywords:
Carpal instabilityDynamic CTScaphoid kinematicsScapholunate

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Radiology

Background:

  • Scapholunate instability (SLI) is characterized by the dissociation of the scaphoid from the proximal carpal row.
  • The scaphoid's motion is hypothesized to be primarily driven by the distal carpal row in SLI.

Purpose of the Study:

  • To describe the 6 degrees of freedom kinematics of the scaphoid bone in both normal and SLI wrists using dynamic CT scans.
  • To test the hypothesis that scaphoid motion in SLI conforms to distal carpal row kinematics.

Main Methods:

  • Dynamic CT scans were acquired from 17 SLI and 17 normal wrists during ulnar-to-radial deviation and extension-to-flexion.
  • Radio-scaphoid angles and centroid positions were calculated in neutral and dynamic wrist positions.
  • The scapho-capitate motion index (SCI) was computed to quantify relative scaphoid and capitate motion.

Main Results:

  • In the neutral wrist position, SLI scaphoids exhibited flexion, internal rotation, and radial translation compared to normal.
  • During wrist motion, SLI scaphoids demonstrated increased 'in-plane' and decreased 'out-of-plane' motion.
  • A higher SCI was observed in SLI wrists during radial deviation and extension phases.

Conclusions:

  • The study describes scaphoid malalignment and 6-DOF kinematics in SLI wrists.
  • Findings support the hypothesis that SLI scaphoid motion aligns with distal carpal row kinematics.
  • This kinematic data may aid in refining surgical reconstruction strategies for SLI.