Search results

Search:
in the keywords: scapholunate dissociation

Sort By:

Limit search:

Proposition of a new classification for scapholunate instability

100%

Elsaftawy A.

vol. 85

issue 11

676-680

Scapholunate (SL) instability is the most common pattern of instabilities in the wrist. If untreated or undiagnosed, it may lead to degenerative changes with SLAC (scapholunate advanced collapse) wrist. There are a few of of well-known SL instability classifications. The one that takes into account a dynamic or static nature of SL instability is the most accepted and used. The arthroscopic classifications are also becoming more and more popular. The aim of the study was the critical review of most popular classifications of SL instability, yet at the same time we proposed a new SL instability classification. Results. The new classification was found to be very useful in the process of diagnosis and decision making concerning further treatment of patients with SL instability in our department. Conclusions. The proposed new classification combines the opportunity of evaluating the scapholunate interosseus ligament (SLIL) tear and lesions of the secondary static stabilizers of SL ligament complex that can coexist with or without DISI deformity (Dorsal Intercalated Segmental Instability).

Radial Wrist Extensors as a Dynamic Stabilizers of Scapholunate Complex

86%

Elsaftawy A.

vol. 85

issue 8

452-459

Wrist stabilization is ensured by the complex of stabilizers, both static (intrinsic and extrinsic ligaments) and dynamic ones (flexor and extensor sinews of the wrist). Extrinsic carpal ligaments link both carpal rows with forearm, while the intrinsic ones connect individual carpal bones. From among intrinsic ligaments, the most significant from clinical point of view is scapholunate ligament (scapholunate lig. - SL). Instability of the SL resulting from SL ligament tear is the most frequent type of carpal instability. If untreated or undiagnosed, it may lead to destabilization of the carpal rows, and in the final stage to massive degenerative changes with SLAC (scapholunate advanced collapse). The aim of the study was to present a hypothesis of a possible influence of radial extensors of the wrist as dynamic stabilizers for SL complex, based on which it is possible to discern the partial ligament tear with accompanying damage of static stabilizers of the complex. Material and methods. This hypothesis was based on radiological tests carried out on 5 patients, with acute partial SL ligament tear, which was confirmed during wrist arthroscopy. The outcome was presented as well, with its visualization in radiological tests. Results. The picture of rotary subluxation of the scaphoid -signet ring sign in PA view and strengthening in stress position (clenched fist) was demonstrated in all 5 patients. In 2 patients who had wrist arthroscopy performed it was observed that the palmar and proximal part of SL ligament were injured, yet no damage of dorsal part was reported. In MRI tests of these patients, an additional injury of dorsal intercarpal ligament was revealed. Conclusions. Correction of the scaphoid reduction in position of clenched fist may result from influence of radial extensors of the wrist (both short and long) as dynamic stabilizers of SL complex. This imagining is a completion of the radiological symptoms so far occurring in this SL instability. In case of acute, partial scapholunate ligament tear, reduction of scapholunate subluxation and its internal fixation with the lunate and capitate for a 6-week period may be an optional procedure

Refine search results

2 Polish Journal of Surgery

2 2013

2 Elsaftawy A.

Search results

Proposition of a new classification for scapholunate instability

Radial Wrist Extensors as a Dynamic Stabilizers of Scapholunate Complex