Wrist ligaments: their significance in carpal instability.
BACKGROUND
Understanding the exact contribution of the supporting ligaments to the functional integrity of the wrist is crucial for the diagnosis and treatment of carpal instabilities. The present study evaluates functional significance of the wrist ligaments with respect to carpal instabilities.


METHODS
Sixteen fresh cadaver wrists were dissected. Extrinsic and intrinsic ligaments of the wrists (ligamentum radioscaphocapitatum, ligamentum radiolunotriquetrum and ligamentum triquetrohamatocapitatum) were sectioned sequentially. After sectioning of each ligament, the wrist was examined for clinical signs of instability such as misalignement of carpal bones, limited range of motion and dorsal translation. When instability was suspected, radiographs were taken and if instability was confirmed, then the ligament was repaired.


RESULTS
Although none of the dorsal ligaments sectioning resulted in instability, sectioning of ligamentum scaphotrapeziotrapezoideum, ligamentum radioscaphocapitatum, ligamentum radiolunotriquetrum and ligamentum triquetrohamatocapitatum displayed scaphotrapeziotrapezoidal, dorsal intercalated segment, lunotriquetral and capitohamate instability respectively. In two wrists with arthrosis, sectioning of all ligaments didn't lead to any instability.


CONCLUSIONS
Instability of the wrist can be classified on anatomical basis after the name of these four ligaments involved i.e. l. scaphotrapeziotrapezoideum, l. radioscaphocapitatum, l. radiolunotriquetrum and l. triquetrohamatocapitatum respectively . This approach clarifies the etiology and treatment of carpal instabilities.
Ozçelik
Abdurrahman
A
Department of Orthopaedics, Osmangazi University Hospital, Eskişehir, Turkey. aozcelik@ogu.edu.tr
Günal
Izge
I
Köse
Nusret
N
Seber
Sinan
S
Omeroğlu
Hakan
H
D002102:Cadaver; D002348:Carpal Bones; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D011859:Radiography; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery