Arthroscopic Anatomy and Lesions of the Extrinsic Ligaments

Overstraeten, Luc Van

doi:10.1007/978-2-8178-0379-1_9

Cited by 5 publications

(26 citation statements)

References 23 publications

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“…Before sectioning the ligaments, an arthroscopic hook test was performed to evaluate the integrity of the radioscaphocapitate (RSC), volar scaphotrapezial ligament (ST), and long radiolunate (LRL) ligaments. 26 The dorsal radiocarpal (DRC) and dorsal intercarpal (DIC) ligaments were assessed through arhtroscopic portals with a hook extra-articularly. 26 The DRC is in fact palpable by sliding the probe along the proximal surface of the triquetrum while hooking the dorsal insertion of the ligament on the triquetrum; it is easier to check it after shaving the dorsal synovium.…”

Section: Methodsmentioning

confidence: 99%

“…26 The dorsal radiocarpal (DRC) and dorsal intercarpal (DIC) ligaments were assessed through arhtroscopic portals with a hook extra-articularly. 26 The DRC is in fact palpable by sliding the probe along the proximal surface of the triquetrum while hooking the dorsal insertion of the ligament on the triquetrum; it is easier to check it after shaving the dorsal synovium. The DIC is palpated by sliding the probe from volar to dorsal on the distal suface of the proximal third of the scaphoid.…”

Section: Methodsmentioning

confidence: 99%

“…The DIC is typically the most difficult to be tested by classic midcarpal portals and may sometimes require a specific additional portal MC1-3. 26 Specimens that presented with associated SLIOL lesions or extrinsic ligament lesions were excluded from the study. Thirteen wrists were then available for the study.…”

Section: Methodsmentioning

confidence: 99%

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The EWAS Classification of Scapholunate Tears: An Anatomical Arthroscopic Study

Messina

Overstraeten

Luchetti³

et al. 2013

Jnl Wrist Surg

101

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Scapholunate interosseous ligament (SLIOL) tears, according to the studies of Mayfield, develop in a predictable pattern after a trauma in extension, ulnar deviation, or intercarpal supination. The volar part of the scapholunate ligament is involved first, then the whole SLIOL, then the extrinsic ligaments such as the radioscaphocapitate (RSC) ligament and the radiotriquetral (RT) ligament with a variable degree of ligament damage. 1They occur mainly in young patients of working age, who may develop wrist instability, which can eventually lead to degenerative arthritis and a scapholunate advanced collapse (SLAC) wrist.2,3 Once arthritis has developed, the treatment of these lesions is not simple and generally requires salvage procedures with a significant loss of wrist function. Treatment of a chronic scapholunate ligament tear is still a challenge for the surgeon, even before wrist arthritis has developed, since it is not always possible to regain complete wrist strength, motion, and AbstractTreatment of scapho-lunate (SL) injuries is still a challenge for the surgeon, especially in chronic cases. The aim of the study isto experimentally cut, specific portions of scapholunate ligament and extrinsic ligaments and check their corresponding arthroscopic finding in order to understand the pathogenesis and develop a new classificationsystem which is an evolution of the present arthroscopic classifications. Materials and Methods Thirteen cadaver wrists were studied under arthroscopy. Different portions of the scapho-lunate ligament were subsequently sectioned. In group A the sectioning sequence was: anterior SLIOL, RSC, LRL, SLIOL's proximal and posterior, DIC, DRC ligament and ST ligaments (8 cases). In group B it was: SLIOL's posterior and proximal, DIC, SLIOL's anterior, LRL, RSCL, DRC, ST ligaments (5 cases). The anatomo-pathological findings after each sectioning were correlated to the classification system proposed (

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The EWAS Classification of Scapholunate Tears: An Anatomical Arthroscopic Study

Messina

Overstraeten

Luchetti³

et al. 2013

Jnl Wrist Surg

101

View full text Add to dashboard Cite

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“…The dynamic approach is necessary to assess stability of the wrist and to guide the choice of technique for potential surgical repair. 9,16,17 Another limitation of diagnostic wrist arthroscopy is its invasiveness compared with imaging methods.…”

Section: Arthroscopymentioning

confidence: 99%

“…connect two nonadjacent carpal bones. To facilitate understanding of the pathologies, the ligaments have been subdivided in five groups: 6,16 -Palmar radiocarpal ligaments: RSC, RLT (LRL, SRL), RSL -Ulnocarpal ligaments: UL, UT (palmar and dorsal) -Dorsal radiocarpal ligament: dorsal RC (or RLT) -Midcarpal ligaments: dorsal IC (dorsal TS, TTT) and palmar TS…”

Section: Arthroscopymentioning

confidence: 99%

Pathology of Extrinsic Ligaments: A Pictorial Essay

Shahabpour

Overstraeten

Ceuterick

et al. 2012

Semin Musculoskelet Radiol

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The role of the extrinsic ligaments, together with the intrinsic ligaments, appears to be much more important than previously thought in the setting of carpal stability. The anatomy and pathology of the extrinsic wrist ligaments is complex. Magnetic resonance imaging (MRI) with thin slices is essential for visualization. This article describes the pathological appearance of the extrinsic palmar and dorsal radiocarpal and ulnocarpal ligaments on MRI, correlated with arthroscopy (performed by two skilled hand surgeons), clinical findings, and follow-up. High-resolution MRI, especially using isotropic three-dimensional sequences with orthogonal multiplanar reconstructions on 3T MR systems, allows detailed depiction of many of the extrinsic ligaments affected in carpal injuries. Recognition of ligament abnormalities is improved by intra-articular or intravenous injection of contrast before the examination. Both techniques may help to determine the precise localization, size, and extent of dorsal and palmar radiocarpal and ulnocarpal ligament lesions. Further experience with these techniques is needed to define the place of MRI in the management of traumatic wrist injuries.

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Arthroscopic Repair of the Dorsal Intercarpal Ligament Detachment from the Scaphoid

Merlini

Mathoulin

2021

J Wrist Surg

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Background The dorsal intercarpal ligament, whose role in dorsal stability of the wrist has been shown, can be harmed in case of injury to the dorsal scapholunate complex. However, dorsal intercarpal ligament injury also seems to exist isolated posttraumatic forms of dorsal intercarpal ligament rupture, much rarer, through bony avulsion on its scaphoid insertion. The authors report the first description of this lesion, and propose a technique for arthroscopic repair. Description of Technique Radiocarpal arthroscopy will confirm the bony avulsion of the dorsal intercarpal ligament from the scaphoid. Under arthroscopic control, an anchor can be placed into the dorsal aspect of the scaphoid and the ligament can be reattached along with the dorsal capsule. Patients and Methods Between 2018 and 2020, seven patients underwent arthroscopic repair of this particular injury. They presented a painful preoperative wrist with decreased range of motion, and were treated arthroscopically, with anchored reinsertion of the ligament on the scaphoid. Results After a mean follow-up period of 12 months, arthroscopic repair showed decreased pain (6.7 to 0.2), improved range of motion in flexion (66 to 82 degrees) and extension (57 to 87 degrees°), and improved Disabilities of the Arm, Shoulder, and Hand (DASH) score (68.45 to 2.23). Conclusions This lesion has so far never been reported in the literature, and seems mechanically different from more common injuries of the scapholunate complex and dorsal capsulo-scapholunate septum with which dorsal intercarpal ligament ruptures are frequently associated. Arthroscopic repair with an anchor is possible without difficulty and seems to give very good results at 1-year follow-up (normal strength and range of motion).

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Arthroscopic Anatomy and Lesions of the Extrinsic Ligaments

Cited by 5 publications

References 23 publications

The EWAS Classification of Scapholunate Tears: An Anatomical Arthroscopic Study

The EWAS Classification of Scapholunate Tears: An Anatomical Arthroscopic Study

Pathology of Extrinsic Ligaments: A Pictorial Essay

Arthroscopic Repair of the Dorsal Intercarpal Ligament Detachment from the Scaphoid

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