The Effect of Volar Scapholunate Tears on Carpal Kinematics

Description

In this presentation, Sydney Robinson discusses the significant impact of volar scapholunate interosseous ligament (SLIL) tears on wrist carpal kinematics. SLIL tears, commonly occurring between the scaphoid and lunate, are identified as the most prevalent ligamentous injuries in the wrist. The presentation highlights the diagnostic challenges associated with early detection of these tears, noting that traditional methods often miss dynamic instability as they primarily capture late-stage conditions. The use of advanced imaging technology, particularly four-dimensional computed tomography (4DCT), is explored as a solution to this diagnostic gap, enabling the visualization of abnormal bone movements during wrist motion.



Robinson outlines a pilot study involving six participants, three without wrist pain and three diagnosed with MRI-proven SLIL tears. Through unilateral 4DCT imaging, the study captures the in vivo rotational dynamics of the scaphoid during various wrist movements. Data processing allowed for the calculation of helical axes of bone rotation, comparing healthy and affected individuals' results.



The findings reveal distinct patterns of abnormal scaphoid rotation associated with different types of SLIL tears, particularly noting that volar tears exhibit notable deviations. In conclusion, Robinson emphasizes that 4DCT proves to be a promising diagnostic tool for detecting subtle rotational differences indicative of SLIL tears, suggesting that volar tears may require surgical intervention due to their potential to disrupt normal carpal motion.

DOI: 10.1302/3114-220910

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