Base anatomique d'un nouveau concept de stabilit� du carpe

Abstract

Based on anatomical and biomechanical evidence, we conclude that the stability of the carpus relies on the lunate bone which is the centre of the longitudinal as well as the transverse functional axis. The lunate is firmly stabilised proximally to the radius and the radio-ulnar ligament complex by the proximal V-ligament, and so becomes a weight bearing structure. It is anchored by strong ligaments to the scaphoid on one side and the triquetrum on the other, thus forming a 3-bone intercalary system, which is in turn guided by the palmar distal V-ligament and the dorsal radio-triquetral ligament.

Association Between Lunate Morphology and Carpal Collapse in Cases of Scapholunate Dissociation

“…1,8,9 The wide variation on the incidence of type II lunates is thought to be due to differences in research methods, angle measurement, and differences in populations studied. 24 For example, Dharap et al found that the incidence of type II lunates was 39% in Arab subjects from Bahrain, whereas type II lunates existed in 66% of Bulgarian subjects in another study. 9,26 Lunate type has been classified by one of two methods in the literature.…”

“…24 Alterations in the radiographic position of the lunate result in the development of the carpal instability dissociative patterns of DISI or volar intercalated segment instability. DISI is commonly known to occur after a scaphoid nonunion or disruption of the scapholunate ligament.…”

Association Between Lunate Morphology and Carpal Collapse Patterns in Scaphoid Nonunions

“…1,2 This title is well deserved, as this carpal bone is uniquely positioned at the middle of both the transverse and coronal arches of the carpus. Critical ligamentous attachments between the lunate, the scaphoid, and the triquetrum allow for stability within the proximal carpal row.…”

Arthroscopie du poignet: apport diagnostique et th�rapeutique

“…a Insuffisance SL: r6duction du scaphoi'de par ligamentoplastie selon le principe de Blatt, b Rdmise sous tension de la sangle ligamentaire palmaire (ligament scapho-triqnetrale palmaire) par augmentation dorsale aussi ~tonnant de constater que le compartiment cubital est plus sensible aux 16sions, ce que la radiologie standard n'a pas permis de mettre en 6vidence jusqu'ici. Ces donn6es ne s'opposent pas aux concepts de stabilit~ propos& par Sennwald et Segmuller [15,16] ni ~ celui de Lichtmann et coll. [8].…”