Biomechanical Evaluation of Wrist Ligament Injuries Rept. for 30 Sep 99-29 Sep 02

摘要

The purpose of this project has been to understand the kinematics, biomechanics, and patho-mechanics of the scaphoid and lunate, which are the carpal bones most commonly involved in wrist instability. The project used a wrist joint motion simulator to move cadaver wrists through prescribed ranges of motion while the three dimensional motion of the scaphoid, lunate, and third metacarpal were monitored using a Fastrak (trademark) electromagnetic motion measuring sensor on each bone. The motion was recorded with the wrist intact and after sequential sectioning of three ligaments which simulates injury to these ligaments. These structures attach to the scaphoid; specifically the scapholunate interosseous ligament (SLIL), the radioscaphocapitate ligament (RSC), and the scaphotrapezial ligament (ST). These ligaments were chosen because of the clinical observation that these structures are frequently damaged after trauma. Our overall goal was to determine the relative importance of these ligaments in stabilizing the scaphoid and lunate, as well as to examine the effectiveness of one surgical repair. The first specific aim of this study was to determine if insertion of a thin pressure sensor in the radiocarpal joint would alter carpal motion. The second specific aim of this study was to evaluate the contribution of the SLIL, RSC and the ST ligaments in stabilizing the scaphoid and lunate individually and in various combinations. The third specific aim of this study was to evaluate a commonly used surgical reconstruction for wrist instability.