Relevant anatomy and biomechanics A pure perilunate injury involves a dislocation of the carpus from the lunate, and constitutes a purely ligamentous injury to the wrist. Pure perilunate dislocations are considered lesser arc injuries because the traumatic force results in…
Relevant biomechanics and natural history The development of osteoarthritis (OA) following displaced intraarticular fractures has been attributed to a variety of factors, including the initial trauma to cartilage, elevated contact stresses, and joint instability. Early cadaveric studies of simulated intraarticular…
Distal radius fractures (DRF) occur as a consequence of trauma and they are one of the most common types of fractures. There is a bimodal distribution with high-energy fractures occurring in younger people, mostly males, and low-energy fractures occurring in…
Relevant anatomy and biomechanics The scaphoid bone is the only carpal bone that bridges both the proximal and distal rows. As a result it is subjected to continuous shearing and bending forces. The scaphoid is tilted in 40 ± 3…
Relevant anatomy and biomechanics Many investigators have contributed to the understanding of midcarpal instability (MCI), which Lichtman consolidated into classifications ( Table 9.1 ). MCI represents several distinct clinical entities differing in the cause and direction of subluxation but sharing…
Various authors have cast light on the importance of the dorsal radiocarpal ligament (DRCL) in maintaining carpal stability. Tears of the DRCL have been linked to the development of both volar and dorsal intercalated segmental instabilities and may be implicated…
Relevant anatomy and biomechanics The lunotriquetral interosseous ligament (LTIL) is C -shaped, similar to the scapholunate interosseous ligament (SLIL), and consists of true ligamentous dorsal and palmar subregions and an intervening fibrocartilaginous membranous portion. The palmar region is the thickest…
Relevant anatomy and biomechanics The scapholunate interosseous ligament (SLIL) is a C -shaped structure connecting the dorsal, proximal, and palmar surface between the scaphoid and the lunate, leaving the distal aspect of the joint bare. The SLIL has three subcomponents:…
Relevant anatomy and biomechanics Ulnar impaction can produce ulnar-sided wrist pain and can be related to ulnocarpal impaction (UCI) due to an ulnar-positive variance ( Fig. 5.1 ). Palmer et al. demonstrated that there was an inverse relationship between the…
Relevant anatomy and biomechanics Triangular fibrocartilage complex anatomy The triangular fibrocartilage complex (TFCC) consists of the articular disc, the meniscus homologue, the palmar radioulnar ligament (PRUL) and dorsal radioulnar ligament (DRUL), the extensor carpi ulnaris subsheath (ECUS), the ulnar capsule,…