Correction of dorsi-flexed intercalated segment instability after restoration of scaphoid height in a cadaver model of scaphoid non-union.
Models of scaphoid non-union with static dorsi-flexed intercalated segment instability were produced in five frozen arms from cadavers or subjects following accidents by repetitive mechanical loading of the wrist joints longitudinally after a bone defect has been made at the mid-portion of the scaphoid. We designed four models of reduction: anatomical reduction; reduction with a shortened scaphoid; anatomical reduction but with the radio-lunate ligament sectioned, and a shortened scaphoid with the radio-lunate ligament sectioned. Results suggested that anatomical reduction with rigid fixation with a Herbert screw was most effective for correction of malalignment with DISI. Preservation of the radio-lunate ligament during the palmar approach to the scaphoid seemed to be important to prevent ligamentous carpal instability.
Department of Orthopaedic Surgery, Osaka City University Medical School, Japan.
M
M
Yasuda
M
M
Kusunoki
K
K
Kazuki
Y
Y
Yamano
D001863:Bone Screws; D016025:Bone Transplantation / Q000009:adverse effects; D002348:Carpal Bones / Q000293:injuries* / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008954:Models, Biological