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

• Published in: The Journal of hand surgery, European volume European volume, 2019-06, Vol.44 (5), p.479-487
• Main Authors: de Roo, Marieke G. A., Muurling, Marijn, Dobbe, Johannes G. G., Brinkhorst, Michelle E., Streekstra, Geert J., Strackee, Simon D.
• Format: Article
• Language: English
• Subjects: Adult; Biomechanical Phenomena - physiology; Carpal Joints - diagnostic imaging; Carpal Joints - physiology; Female; Four-Dimensional Computed Tomography; Full Length; Healthy Volunteers; Humans; Lunate Bone - diagnostic imaging; Lunate Bone - physiology; Male; Rotation; Scaphoid Bone - diagnostic imaging; Scaphoid Bone - physiology; Young Adult
• ISSN: 1753-1934; 2043-6289
• DOI: 10.1177/1753193419830924

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.