Role of muscles in the stabilization of ligament-deficient wrists

Esplugas, Mireia; García-Elias, Marc; Lluch, Àlex; Llusá, Manuel

doi:10.1016/j.jht.2016.03.009

Cited by 51 publications

(32 citation statements)

References 31 publications

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“…The differences in size that we have observed in the insertion site of the RSC + LRL ligaments in our four species of primates may also be related to anatomic characteristics of the muscles that stabilize the wrist. The FCR and the APS play an important role in stabilizing the radial and palmar region of the wrist and assist the RSC + LRS ligaments in stabilizing the scaphoid (Esplugas, Garcia‐Elias, Lluch, & Llusá, ; Whitehead, ). Our 3D GM analysis revealed a progression from largest to smallest relative size of the insertion site of the RSC + LRL ligaments among H. sapiens > P. pygmaeus > knuckle‐walker primates.…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional geometric morphometric analysis of the distal radius insertion sites of the palmar radiocarpal ligaments in hominoid primates

Casado

Punsola

Gómez

et al. 2019

American J Phys Anthropol

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Objectives: To identify anatomic differences in the insertion sites of the palmar radiocarpal ligaments in different species of hominoid primates that may be related to their different types of locomotion. Materials and methods:We have used three-dimensional geometric morphometrics (3D GM) to analyze the distal radius ligament insertion sites in 31 Homo sapiens, 25 Pan troglodytes, 31 Gorilla gorilla, and 15 Pongo pygmaeus. We have also dissected the radioscaphocapitate (RSC), long radiolunate (LRL) and short radiolunate (SRL) ligaments in six H. sapiens and five P. troglodytes to obtain quantitative values that were then compared with the results of the 3D GM analysis.Results: H. sapiens had a relatively larger insertion site of the RSC + LRL ligament than the other hominoid primates. P. pygmaeus and P. troglodytes had a relatively large SRL ligament insertion site with a palmar orientation. In G. gorilla, the two ligament insertion sites were relatively smaller and the SRL insertion site had an ulnopalmar orientation.Discussion: The morphological differences observed can be related to the types of locomotion used by the different species and to quantitative data obtained from the dissection of ligaments in H. sapiens and P. troglodytes. 3D GM analysis of ligament insertion sites can help in interpreting the types of locomotion used by extinct hominoid primates through the analysis of preserved fossilized fragments of the distal radius. K E Y W O R D Sdistal radius, hominoid primates, radiocarpal ligaments

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Section: Discussionmentioning

confidence: 99%

Three‐dimensional geometric morphometric analysis of the distal radius insertion sites of the palmar radiocarpal ligaments in hominoid primates

Casado

Punsola

Gómez

et al. 2019

American J Phys Anthropol

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“…5 In addition, as previously described, with wrist positioned in supination, the extensor carpi ulnaris acts as a distal carpal pronator, further accentuating the scapholunate gap. 6 In this study, we found that the Twist X-rays demonstrated substantially greater gapping of the scapholunate interval when compared with the clenched fist and pencil grip views. Furthermore, the majority of the pencil grip measurements were within normal limits (less than 2 mm) despite there being clear disruption of the scapholunate ligament.…”

Section: Discussionmentioning

confidence: 49%

“…The wrist is positioned in supination to harness the force of extensor carpi ulnaris as a distal carpal pronator and further accentuate the scapholunate gap. 6 The Twist views, which we have developed, are stress Xray views that combine the clenched fist view with ulnar deviation, increased grip force, and supination. This device was designed to reproduce the common patient complaint of pain when trying to open a jar or turning a doorknob.…”

Section: The Device and The Twist Viewsmentioning

confidence: 99%

The Twist X-Ray: A Novel Test for Dynamic Scapholunate Instability

et al. 2018

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Background Scapholunate instability (SLI) is the most common form of carpal instability. Early detection of SLI is imperative as early reconstructive procedures can potentially prevent the natural history of progressive degenerative arthritis. After wrist arthroscopy, magnetic resonance imaging (MRI) remains the next best noninvasive diagnostic option; however, access still remains costly and is often limited in many health care systems worldwide. In this article, we describe a novel device that allows for dynamic X-rays to be taken, accentuating the scapholunate (SL) widening. Description of Technique Twist X-ray views are generated by the patient clenching a device that combines the standard clenched fist views with ulnar deviation and supination. The test is easy to perform and functions by combining a higher grip force with the ulnar deviation and pronation effects of the extensor carpi ulnaris tendon, thus accentuating the SL gap in dynamic instability. Patients and Methods We present a series of four patients with dynamic SLI and compare the findings of the Twist X-rays with conventional wrist X-rays series, including standard anteroposterior, lateral, radial, and ulna deviation, clenched fist, and pencil grip views. Results In all the four patients, there was substantial dynamic SL widening. The SL interval increased from a mean of 1.8 mm (range: 1.5–2.8) on posteroanterior X-rays to 6.3 mm (range: 4.6–8.2) with the Twist views. Interestingly, on the pencil grip view, the mean widening was only 1.5 mm (range: 1–2.8 mm). Conclusion The authors describe a novel device that allows for improved detection of dynamic SL ligament instability when performing stress X-ray views of the wrist. Level of Evidence This is a Level IV study.

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“…A esto debemos añadir los datos de estudios recientes en cadáver realizados por Esplugas et al 17 . Partiendo de la base de que el tendón del ECU presenta una oblicuidad de unos 30 • en la posición de máxima supinación del antebrazo ( fig.…”

Section: Potenciación Selectiva De Determinados Grupos Musculares Queunclassified

El papel de la rehabilitación tras las reparaciones de las inestabilidades de muñeca

Lerma¹,

Baixauli²,

Selma³

et al. 2016

Rev Iberoam Cir Mano

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PALABRAS CLAVERehabilitación; Inestabilidad; Propiocepción; Muñeca Resumen De las patologías de muñeca más frecuentes en la consulta del cirujano de la mano, las inestabilidades carpianas ocupan un lugar importante junto con el dolor en la vertiente ulnocarpiana cuya causa más frecuente son las lesiones del complejo fibrocartílago triangular, que en ocasiones van a condicionar una inestabilidad de la articulación radiocubital distal. Analizando los datos anatómicos y biomecánicos que diponemos de la muñeca y tomando como punto de partida los escasos protocolos rehabilitadores de las inestabilidades escafolunares y lunopiramidales que existen en la bibliografía, se exponen los programas rehabilitadores específicos para cada una de ellas. Se describen también los protocolos existentes para la rehabilitación tras las reparaciones del complejo fibrocartílago triangular y exponemos los protocolos con los que trabajamos en la actualidad.Definimos también la importancia de la reeducación propioceptiva en este tipo de lesiones y describimos un programa detallado de introducción progresiva de determinados ejercicios encaminados a ello. © 2016 SECMA. Publicado por Elsevier España, S.L.U. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/). KEYWORDS Rehabilitation; Instability; Proprioception; WristThe role of rehabilitation after repair of wrist injuries Abstract One of the most frequent wrist pathologies seen by the hand surgeon are the carpal instabilities together with the pain in the ulnocarpal side. The most common causes are due to injuries in the fibrocartilage triangular complex. These injuries sometimes may cause an instability of the distal radio-ulnar joint. After an analysis of the anatomical and biomechanical data, and taking the few rehabilitation protocols of scapholunate and lunotriquetral instabilities published in the literature, specific rehabilitation programs for each one of these * Autor para correspondencia. Correo electrónico: evaguisa@yahoo.es (E. Guisasola Lerma).

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Role of muscles in the stabilization of ligament-deficient wrists

Cited by 51 publications

References 31 publications

Three‐dimensional geometric morphometric analysis of the distal radius insertion sites of the palmar radiocarpal ligaments in hominoid primates

Three‐dimensional geometric morphometric analysis of the distal radius insertion sites of the palmar radiocarpal ligaments in hominoid primates

The Twist X-Ray: A Novel Test for Dynamic Scapholunate Instability

El papel de la rehabilitación tras las reparaciones de las inestabilidades de muñeca

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