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Defining the Anatomy of the Dorsal Scapholunate Interosseous Ligament with the Use of High Frequency Ultrasound Imaging
Mary Claire B Manske, MD; Jerry I Huang, MD
University of Washington Medical Center, Seattle, WA
Introduction: The anatomy of the scapholunate interosseous ligament (SLIL) has been described qualitatively in great detail, with recognition of the dorsal component as the most important for carpal stability. The goals of surgical repair are to restore the native anatomy and carpal stability. However, the anatomy of the dorsal SLIL has not been quantitatively defined. The purpose of this study is to provide a quantitative description of the anatomy of the dorsal scapholunate interosseous ligament.
Materials & Methods: We recruited 20 volunteers (40 wrists) without hand or wrist complaints to participate in the study. A high frequency ultrasound was used to evaluate the dimensions of the dorsal SLIL, as well as the width of the scapholunate interval, both at the dorsal margin and central portion of the joint. Next, 12 cadaveric wrists were obtained and underwent both ultrasound evaluation and gross dissection to determine the dorsal SLIL morphology including length, thickness, and location of insertions on the scaphoid and lunate.
Results: In the 40 wrists, the mean dorsal SLIL length was 7.54mm and thickness was 1.81mm. The mean scapholunate interval was 4.97mm dorsally and 2.50mm centrally. There was no significant difference between dominant and non-dominant wrists. In the cadaveric specimen, on ultrasound imaging, the mean dorsal SLIL length was 6.23mm and mean thickness was 1.63mm. With gross dissection, the mean length measured 6.45mm and mean thicknesss measured 1.55mm. There was a moderately strong correlation with respect to dorsal SLIL length between ultrasound and gross measurements (R = 0.48) and poor correlation when looking at SLIL thickness (R = 0.28). On ultrasound imaging, the SLIL insertion on the scaphoid and lunate was 1.04mm and 2.21mm from the articular margin, respectively on ultrasound imaging, compared to 1.55mm and 2.57mm, respectively on gross anatomic measurements.
Conclusion: This is the first quantitative anatomic study of the dorsal SLIL, demonstrating an SLIL length of approximately 6-8mm and an SLIL thickness of 1.01 to 2.61mm (95% CI). The dorsal SLIL inserts near the articular surface of the scaphoid over the dorsal ulnar aspect and inserts over the dorsal horn of the lunate, approximately 2.0-2.5 mm from the articular surface. These parameters may be useful in surgical treatment of SLIL injuries to restore the native anatomy. High frequency ultrasound imaging is an effective technique for assessment of dorsal scapholunate ligament anatomy.
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