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The carpal stretch test at the scapholunate joint
S Yamaguchi1, M Beppu, K Matsushita
1Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.
The Journal of Hand Surgery
|August 26, 1998
Summary
The carpal stretch test can help identify subtle scapholunate dissociation. This test reveals changes in wrist joint alignment and deformities, aiding in diagnosis.
Area of Science:
- Orthopedics
- Anatomy
- Biomechanics
Background:
- Scapholunate dissociation is a common wrist injury.
- Accurate diagnosis is crucial for effective treatment.
- The carpal stretch test is a clinical maneuver used to assess wrist stability.
Purpose of the Study:
- To evaluate the diagnostic principle of the carpal stretch test.
- To determine the test's sensitivity in detecting scapholunate dissociation.
Main Methods:
- Utilized 11 cadaver upper extremities and 40 normal volunteer wrists.
- Analyzed intercarpal distances and scapholunate joint step-off deformities via X-ray.
- Sequentially sectioned wrist ligaments in cadavers to simulate dissociation stages.
Main Results:
- Increased carpal interval ratios were observed with progressive ligamentous injury.
- Step-off deformities at the scapholunate joint were detected in staged cadaver wrists.
- The carpal stretch test identified these deformities in multiple stages of dissociation.
Conclusions:
- The carpal stretch test may be valuable for diagnosing occult and dynamic scapholunate dissociation.
- The test's efficacy was demonstrated in cadaveric models with simulated ligamentous injury.