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How does Wrist Position Affect Tension across the Scapholunate Interosseous Ligament: An in vivo 3-dimension Image Study
Jing Chen1; Jun Tan1; Wei Feng Mao2; Ya Fang Wu1
1Affiliated Hospital of Nantong University, Nantong, China, 2Nantong University, Nantong, China

Introduction: The wrist positions vary substantially in daily use and labor. The scapholunate interosseous ligament (SLIL) is most commonly injured wrist ligament during wrist action. The tension changes across the scapholunate ligament are unknown at different wrist positions. The aim of this study was to investigate the length changes of SLIL at wrist hyperextension, forearm rotation, and combined wrist hyperextension and forearm rotation in vivo using 3-dimensional image reconstruction.
Methods: We obtained CT scans of the right wrists for 18 volunteers who were divided into three groups with 6 each. CT scans of the wrists were obtained at wrist hyperextension, varying angles of forearm rotation, and combination of wrist hyperextension and forearm rotation respectively. For each wrist, the carpal bones were reconstructed using image reconstruction software, and the lengths of volar (v-SLIL), proximal (p-SLIL), and dorsal (d-SLIL) regions of the SLIL were measured and analyzed with computer modeling.
Results: From the neutral position to hyperextension, the lengths of the v-SLIL and volar and middle portion of the p-SLIL increased significantly. The lengths of v-SLIL and volar, middle portion of p-SLIL increased significantly, whereas the lengths of the distal portion of d-SLIL decreased significantly in extreme forearm pronation. Combination of forearm pronation and hyperextension further increase the length of the v-SLIL and p-SLIL.
Conclusion: There are great changes in the palmar and proximal portions of the SLIL at different wrist positions, but not in dorsal portion of the SLIL. At extreme forearm pronation, the v-SLIL and the p-SLIL were elongated relative to the neutral length. These length changes may reflect the changes in tensional status of the different portions of the interosseous ligament; the parts subjecting to a greater tension may have great risk of injury. This is the first comprehensive in vivo study of length changes of different parts of the SLIL and the findings can be used to assist design of surgical procedures and to set the wrist at proper position after surgery.


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