A four-dimensional-CT study of in vivo scapholunate rotation axes: possible implications for scapholunate ligament reconstruction

Abstract

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.

Intercarpal ligamentoplasty for scapholunate dissociation: comparison of two techniques

“…De Roo et al. (2019) used four-dimensional computerized tomography to study scaphoid motion in healthy wrists.…”

In-Hospital 3D Printed Scaphoid Prosthesis Using Medical-Grade Polyetheretherketone (PEEK) Biomaterial

“…As adhesion is made layer by layer, the printed part will be less weak if the force is applied 90° to the layer and much stronger if the forces are applied along the layer direction, whereas if the center of rotation of the scapholunate axis is oriented perpendicular to the printed layers, the forces of transmission will be in the axial direction. Therefore, we chose the specific orientation of the scaphoid prosthesis for 3D printing [ 25 ]. The suspension of the prosthesis is maintained through a fiber-wire augmented tendon graft, which is passed through the curved channel.…”

Effects of axial load on in vivo scaphoid and lunate kinematics using four-dimensional computed tomography

“…Participants were put in a prone position with one arm 180° abducted; the forearm was placed in a custom-made motion guiding device ( de Roo et al., 2019 ) with the elbow extended and the forearm in pronation fixed to a framework to guide the hand and wrist during the 4-D CT recordings. Metacarpals were placed in a natural position on a handle that was attached to the framework.…”

“…Carpal motion was quantified as rotation in degrees of the scaphoid, lunate and capitate relative to the radius. Flexion (X+), extension (X−), radial deviation (Y+), ulnar deviation (Y−), supination (Z+) and pronation (Z−) were defined as the rotation in degrees around the axes of the anatomical coordinate system of the radius ( de Roo et al., 2019 ; Foumani et al., 2009 ; Kobayashi et al., 1997a ).…”

“…Specific radiographs, such as the clenched fist view, cineradiography, computerized tomography (CT) and magnetic resonance imaging (MRI) provided an initial understanding of wrist kinematics. More recently, dynamic four-dimensional CT (4-D CT) studies have been introduced ( Athlani et al., 2020 ; Carr et al., 2019 ; de Roo et al., 2019 ; Rauch et al., 2018 ; White et al., 2019 ). Current studies using 4-D CT have focused on the gap size between the scaphoid and lunate when axial load is applied or on carpal kinematics during the dart-throwing motion ( Demehri et al., 2016 ; Edirisinghe et al., 2014 ; Garcia-Elias et al., 2014 ; Kelly et al., 2018 ).…”