Diagnosis and Treatment of Acute Lunotriquetral Ligament Injuries

Nicoson, Michael C.; Moran, Steven L.

doi:10.1016/j.hcl.2015.04.005

Cited by 21 publications

(6 citation statements)

References 52 publications

(65 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Given that conventional radiographs are widely available and non-invasive, biomarkers such as C-T distance that take advantage of this modality are practicable in the clinical setting. C-T distance might offer an advantage in assessing suspected LTIL tears over existing measures of sagittal lunate tilt due to the ease of differentiating carpal bones on posteroanterior radiographs compared to lateral radiographs [24]. …”

Section: Discussionmentioning

confidence: 99%

Association of lunate morphology, sex, and lunotriquetral interosseous ligament injury with radiologic measurement of the capitate-triquetrum joint

et al. 2017

View full text Add to dashboard Cite

Objective Radiologic presentation of carpal instability at the radial side of the carpus, e.g. scapholunate diastasis following scapholunate interosseous ligament injury, has been studied extensively. By comparison, presentation at the ulnar-sided carpus has not. The purpose of this study was to assess the effects of lunate morphology, sex, and lunotriquetral interosseous ligament (LTIL) status on the radiologic measurement of the capitate-triquetrum joint (C-T distance). Further, we sought to evaluate the diagnostic accuracy of C-T distance for assessing LTIL injuries. Materials & Methods We retrospectively identified 223 wrists with wrist radiographs and MR arthrograms with contrast injection. Data collected included sex, lunate morphology and LTIL status from MR arthrography, and C-T distance from radiography. The effects of lunate morphology, sex, and LTIL injury status on C-T distance were evaluated using generalized linear models. Diagnostic performance of C-T distance was assessed by the area under receiver-operator characteristic curve (AUROC). Results and conclusion Lunate morphology, sex, and LTIL injury status all had significant effects on C-T distance; wrists with type II lunates, men, and wrists with LTIL injuries had greater C-T distances than wrists with type I lunates, women, and wrists without LTIL injuries, respectively (p<0.01). The diagnostic value of the C-T distance was sufficient for women with type I (AUROC=0.67) and type II lunates (0.60) and good for men with type I (0.72) and type II lunates (0.77). The demonstrated influence of LTIL status on C-T distance supports the use of C-T distance as a tool for assessing full-thickness LTIL tears.

show abstract

Section: Discussionmentioning

confidence: 99%

Association of lunate morphology, sex, and lunotriquetral interosseous ligament injury with radiologic measurement of the capitate-triquetrum joint

et al. 2017

View full text Add to dashboard Cite

show abstract

“…81 Like other ligamentous injuries, the course of intervention varies based on severity, chronicity, and associated degenerative changes, with nonoperative management often indicated for initial treatment of mild injuries. 88 The range of operative interventions includes LT arthrodesis, ligament reconstruction using a distal extensor carpi ulnaris tendon graft, and ligament repair. Study of operative approaches in a largely subacute or chronic patient population revealed that the probability of remaining complication free after 5 years was 68.6% for reconstruction, 13.5% for repair, and less than 1% for arthrodesis with significantly higher subjective indicators of pain relief and satisfaction in those receiving reconstruction or repair.…”

Section: Interosseous Ligamentsmentioning

confidence: 99%

Narrative Review of Ligamentous Wrist Injuries

Margulies

Gopman

et al. 2021

Journal of Hand and Microsurgery

View full text Add to dashboard Cite

Ligamentous wrist injuries are common occurrences that require complex anatomical mastery and extensive understanding of diagnostic and treatment modalities. The purpose of this educational review article is to delve into the most clinically relevant wrist ligaments in an organized manner to provide the reader with an overview of relevant anatomy, function, clinical examination findings, imaging modalities, and options for management. Emphasis is placed on elucidating reported diagnostic accuracies and treatment outcomes to encourage evidence-based practice.

show abstract

“…El mecanismo de lesión del ligamento LP constituye un tema de debate y es menos conocido que el mecanismo de lesión del ligamento EL. Es posible que múltiples mecanismos puedan estar implicados como elementos causales 5 .…”

Section: Mecanismo De Lesiónunclassified

Inestabilidad lunopiramidal

Hernández

Montoya

Gutiérrez³

et al. 2016

Rev Iberoam Cir Mano

View full text Add to dashboard Cite

Artroscopia de muñeca; Ligamento lunopiramidal; Volar Intercalated Segmentary Instability (VISI); Inestabilidad carpianaResumen Históricamente, la inestabilidad en el lado radial de la muñeca ha recibido mucha más atención que la inestabilidad en el lado ulnar, a pesar de ser una patología relativamente frecuente. Como consecuencia de ello, suele darse un retraso en el diagnóstico correcto y el tratamiento apropiado. Las lesiones del ligamento lunopiramidal pueden ser parciales o completas, y estas últimas pueden estar asociadas a lesión de los estabilizadores secundarios. Cuando se lesionan estos estabilizadores es cuando se produce una inestabilidad estática del carpo conocida como Volar Intercalated Segmentary Instability (VISI). Entre los test clínicos más utilizados para detectar una inestabilidad del ligamento lunopiramidal están el Ballottement test, descrito por Reagan, y el Shear test, descrito por Kleinman, aunque ambos poseen una sensibilidad y una especificidad bajas. Para el diagnóstico de estas lesiones se emplean técnicas como la radiografía simple (que suele ser normal si no hay una inestabilidad estática del carpo), la artrografía y la RMN, entre otras, aunque el gold standard lo constituye la artroscopia de muñeca. No existe un consenso en cuanto al tipo de tratamiento óptimo, ya que la mayoría de los estudios publicados son retrospectivos de nivel iv sin medidas objetivas estandarizadas mediante instrumentos validados. Además, en su mayoría describen los resultados del tratamiento tardío, ya que no se suelen diagnosticar en la fase aguda. Dentro de los tratamientos descritos se encuentran el tratamiento artroscópico (desbridamiento/termocoagulación asociados o no a estabilización con agujas de Kirscher), la reparación abierta, la reconstrucción del ligamento y la artrodesis del ligamento lunopiramidal.Abstract Radial-sided wrist instability has historically received greater attention than ulnarsided instability despite being a relatively frequent pathology. As a result, there is often a delay in correct diagnosis and appropriate treatment. Lunotriquetral ligament injuries can be * Autor para correspondencia. Correo electrónico: Montse.ocampos@gmail.com (M. Ocampos Hernández).

show abstract

Diagnosis and Treatment of Acute Lunotriquetral Ligament Injuries

Cited by 21 publications

References 52 publications

Association of lunate morphology, sex, and lunotriquetral interosseous ligament injury with radiologic measurement of the capitate-triquetrum joint

Association of lunate morphology, sex, and lunotriquetral interosseous ligament injury with radiologic measurement of the capitate-triquetrum joint

Narrative Review of Ligamentous Wrist Injuries

Inestabilidad lunopiramidal

Contact Info

Product

Resources

About