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Carpal Pronation and Supination Changes in the Unstable Wrist

机译:腕部不稳定时腕的前旋和旋后变化

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摘要

>Background  Little is known about changes in scaphoid and lunate supination and pronation following scapholunate interosseous ligament (SLIL) injury. Information on these changes may help explain why some SLIL reconstructions have failed and help in the development of new techniques. >Purpose  To determine if following simulated SLIL injury there was an increase in scaphoid pronation and lunate supination and to determine if concurrently there was an increase in the extensor carpi ulnaris (ECU) force. >Materials and Methods  Scaphoid and lunate motion were measured before and after sectioning of the SLIL and two volar ligaments in 22 cadaver wrists, and before and after sectioning of the SLIL and two dorsal ligaments in 15 additional wrists. Each wrist was dynamically moved through wrist flexion/extension, radioulnar deviation, and a dart-throwing motion. Changes in the ECU force were recorded during each wrist motion. >Results  Scaphoid pronation and lunate supination significantly increased following ligamentous sectioning during each motion. There were significant differences in the amount of change in lunate motion, but not in scaphoid motion, between the two groups of sectioned ligaments. Greater percentage ECU force was required following ligamentous sectioning to achieve the same wrist motions. >Conclusion  Carpal supination/pronation changed with simulated damage to the scapholunate stabilizers. This may be associated with the required increases in the ECU force. >Clinical Relevance In reconstructing the SLIL, one should be aware of the possible need to correct scaphoid pronation and lunate supination that occur following injury. This may be more of a concern when the dorsal stabilizers are injured.
机译:>背景鲜知不知道about骨韧带间韧带(SLIL)损伤导致的舟骨和月牙旋后及前旋的变化。有关这些更改的信息可能有助于解释为何一些SLIL重建失败的原因,并有助于开发新技术。 >目的要确定在模拟的SLIL损伤后是否舟骨前旋和月牙旋后增加,并同时确定尺侧腕腕(ECU)力量是否增加。 >材料和方法 were分别在22具尸体腕部切开SLIL和两个掌韧带之前和之后,以及在另外15个腕部切开SLIL和两个背侧韧带之前和之后,测量了舟突和月桂运动。每个腕部通过腕部弯曲/伸展,尺尺偏位和掷镖动作动态移动。在每次腕部运动期间记录ECU力的变化。 >结果 each每次运动中韧带切开后,舟状突前旋和月牙旋后明显增加。两组切片韧带的月经运动变化量(而非舟骨运动)变化量存在显着差异。韧带切片后需要更大百分比的ECU力才能实现相同的腕部运动。 >结论腕骨的旋后/前旋改变了对番龙骨稳定剂的模拟破坏。这可能与所需的ECU力增加有关。 >临床意义在重建SLIL时,应意识到可能需要纠正受伤后发生的舟骨前旋和月牙旋后。当背侧稳定器受伤时,这可能会更加令人担忧。

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