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Experimentally induced ulno-carpal instability. A study on 13 cadaver wrists
L Wiesner1, C Rumelhart, E Pham
1Department of Plastic and Reconstructive Surgery and Burn Unit, University Hospital, Lausanne, Switzerland.
Journal of Hand Surgery (Edinburgh, Scotland)
|February 1, 1996
Summary
The carpus is suspended by ligaments connecting to both the radius and ulna. The ulnar styloid process plays a crucial role in this carpal suspension.
Area of Science:
- Orthopedics
- Anatomy
- Biomechanics
Background:
- Understanding carpal bone suspension is vital for treating wrist injuries.
- Ligamentous structures are traditionally thought to primarily anchor the carpus to the radius.
Purpose of the Study:
- To investigate the role of specific ligamentous structures in suspending the carpal bones from the distal radius and ulna.
- To determine which structures contribute most significantly to carpal stability.
Main Methods:
- Human cadaver wrists underwent surgical fusion (arthrodesis) of the distal radio-ulnar joint and the proximal carpal row.
- Controlled forces were applied to the fused carpal bones, and displacement was measured.
- Various ligamentous structures were sequentially sectioned to assess their impact on carpal displacement.
Main Results:
- Sectioning the ulnar styloid process resulted in the largest average displacement (dorso-palmar and rotational).
- No significant displacement changes were noted after sectioning the extensor retinaculum, extensor carpi ulnaris sheath, posterior ulno-carpal, or posterior radio-carpal ligaments.
Conclusions:
- The carpus is suspended not only from the radius but also from the distal ulna.
- The ulnar styloid process and its associated soft tissues are critical for carpal suspension and stability.