Additional fixation of the palmar scapholunate interosseous ligament has been
advocated to improve the long-term results of dorsal scapholunate interosseous
ligament reconstruction. To investigate the validity of this approach, we
determined normal scapholunate motion patterns and calculated the location of
the scapholunate rotation axis. We hypothesized that the optimal location of the
scapholunate interosseous ligament insertion could be determined from the
scapholunate rotation axis. Four-dimensional computerized tomography was used to
study the wrist motion in 21 healthy participants. During flexion–extension
motions, the scaphoid rotates 38° (SD 0.6°) relative to the lunate; the rotation
axis intersects the dorsal ridge of the proximal pole of the scaphoid and the
dorsal ridge of the lunate. Minimal scapholunate motion is present during
radioulnar deviation. Since the scapholunate rotation axis runs through the
dorsal proximal pole of the scaphoid, this is probably the optimal location for
attaching the scapholunate ligament during reconstructive surgery.
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